Craniectomy, craniotomy, cranioplasty… Medical terms can sound very similar, and things can quickly become confusing as you learn more about your condition and treatment options. Educating yourself is a great way to help develop confidence during this process, but the amount of new information can be overwhelming. To help you better understand some of the terminology, the following information touches on the differences between craniectomy vs craniotomy, including the procedures themselves, the recovery period and risks and benefits of each.

The Procedures

Both craniectomy and craniotomy involve removing a section of the skull, or cranium. The key difference is the skull bone is replaced following a craniotomy, but not during a craniectomy.

Both a craniectomy and craniotomy take place in a hospital setting while you are asleep during general anesthesia. Depending on your individual condition, you may only be scheduled for a craniectomy or craniotomy. However, both procedures are more commonly scheduled in addition to another surgical procedure to treat a condition of the brain. There are many indications for either a craniectomy or craniotomy, some of which are discussed further below.

Reasons for a Craniectomy vs Craniotomy

Other differences between craniectomy vs. craniotomy are the overarching reasons for surgery and the conditions treated. Broadly speaking, a craniectomy is the removal of a section of bone often performed to relieve pressure in an emergency situation. This might be necessary following a stroke or a traumatic brain injury, where the surgeon needs to remove part of the skull to quickly prevent damage from increased intracranial pressure due to fluid buildup and/or swelling. In these cases, two operations are required because the removed part of the skull is replaced several weeks later after swelling has reduced.

A craniectomy may also be used to remove a skull tumor. In this case, the cranioplasty would be done during the time of surgery, as opposed to a trauma, where the patient will come back several weeks later after the brain swelling has reduced to have the required cranioplasty.

On the other hand, the purpose of a craniotomy is typically to get access to an area requiring further treatment. For example, your neurosurgeon may require access to remove a brain tumor, repair a defect or operate on one of the blood vessels of the brain. Recall that the key difference between craniectomy and craniotomy is that following the latter procedure, the bone is removed and replaced during the procedure.

The Risks & Benefits

Before recommending any medical procedure, your personal doctor takes into consideration your individual condition and health factors to ensure the benefits outweigh the risks. While it can be helpful to understand the general risks and benefits of craniectomy and craniotomy, it is important to discuss anticipated outcomes with your personal doctor. He or she will have the most thorough understanding of your specific condition, which may carry additional risks or benefits, along with any other procedures you are having performed.

Craniectomy Risks & Benefits

The most immediate benefit of a craniectomy is the immediate relief of pressure achieved by removing a section of bone. This can be especially important in an emergency situation, where quick action can prevent further damage and even save lives. It is important to keep in mind that a craniectomy is being performed for a reason, and there are likely risks of complications related to the specific condition, such as a stroke or traumatic brain injury, not covered here.

There are general risks associated with any surgical procedure, such as reactions to the anesthesia, infection, and blood clots. Other risks specific to craniectomy include:

  • Inflammation of the brain, called meningitis
  • Infection of the brain or spinal cord
  • Abscess of the brain
  • Brain or nerve damage, resulting in difficulty with speech, movement and other functions
  • Subdural hematoma

Craniotomy Risks & Benefits

The primary benefit of a craniotomy is creating access for the neurosurgeon to reach the area of interest, whether it be a tumor, blood vessel or other structure within the skull. There are different types of craniotomy, but generally speaking, your surgeon will remove as small a section of bone as possible and replace it after your other procedure is complete.

As with a craniectomy, there are general surgical risks that accompany a craniotomy, including bleeding, infection and reactions to general anesthesia. Any lasting ill effects are typically related to the condition being treated or an accompanying surgery. However, some of the complications linked specifically to a craniotomy include:

  • Cerebrospinal fluid leakage, requiring medication or repair
  • Brain swelling
  • Stroke
  • Seizures
  • Brain or nerve damage, resulting in difficulty with speech, movement and other functions

The Recovery Period

Your recovery will be a very personal experience and depends on the condition being treated and your personal health factors. Whether you are undergoing a craniectomy or craniotomy, you can expect a hospital stay of approximately one week, followed by four to 12 weeks of activity restrictions. Again, because both a craniectomy and craniotomy can be used as part of the treatment for many conditions of the brain, you will need to discuss your individual recovery with your own doctor.

Continue the Discussion, Continue to Learn

Now that you have a stronger understanding of craniectomy vs craniotomy, continue the discussion with your personal doctor. It is important to have answers to any lingering questions about your individual condition or upcoming treatment, giving you peace of mind through this process. Becoming more informed can give you confidence about your upcoming treatment, allowing you to rest easy when it matters most.