What is on your mind?

Learning more about your medical condition and upcoming treatment can be like learning a whole new language. The following information explains some of the basics of a craniotomy, including the types of craniotomy and when they might be indicated. The goal is to help you better understand the procedure itself and the role it plays in your treatment path, providing you confidence and peace of mind about your upcoming treatment.

What is a Craniotomy?

Before discussing the types of craniotomy, it’s important to understand the basic procedure itself. During a craniotomy, a surgeon removes a small section of the skull in order to access the area of interest. Following the procedure, the piece of skull is replaced. This should not be confused with another procedure, a craniectomy, where the section of bone is not replaced. Once the bone is replaced, the scalp is closed, typically with sutures or staples.

There are many conditions for which a craniotomy may be part of the treatment. Your doctor may need to gain access to a site to remove a portion of a tumor, correct a vascular malformation or any other treatment goal that requires removal of a portion of the skull. If your doctor has recommended a craniotomy as part of your treatment plan and you have questions, he or she would be the best person to explain the details in your individual case.

The Different Types of Craniotomy

There are different types of craniotomy, classified based on factors such as location, size and the technology used in the procedure. You may come across some of these classifications, either in conversation with your own doctor or while doing your own research, so it can be helpful to review what the different types of craniotomy mean.

Based on Location

Though you may not realize it, your skull is made up of multiple different bones, including the frontal, occipital and temporal bones. You may hear the term “frontal craniotomy.” This means the access is made through the frontal bone of the skull, an area around the forehead. An occipital craniotomy is made in the occipital bone, at the back of the head. Similarly, you may hear the term “temporal craniotomy”, “parietal craniotomy” and so on.

Based on Size

You may also see reference to types of craniotomy based on differences in size. For example, the smallest type of craniotomy is a burr hole craniotomy. Another is a keyhole craniotomy, which is a minimally invasive approach in which the surgeon creates an opening just large enough to fit an endoscope, discussed below.

Based on Surgical Technique

Sometimes types of craniotomy are classified based on the technology or technique used by the neurosurgeon.

One particular type of craniotomy is a stereotactic craniotomy. Stereotactic surgery is the use of three-dimensional imaging to precisely target a treatment area. This procedure is performed in an operating room. Your neurosurgeon will use imaging techniques, such as magnetic resonance imaging (MRI) or computerized tomography (CT) to develop a three-dimensional model of the treatment area. Then, using computer software, the neurosurgeon can determine exactly where to make incisions, reducing the size of the craniotomy and increasing precision.

Follow Up with Your Personal Doctor

Because there are many types of craniotomy and a wide variety of conditions treated with the procedure, it is important to maintain open communication with your personal doctor. He or she will be the best person to discuss which craniotomy technique you will be undergoing, which of the above classifications might apply to you and what you can expect during the recovery process. If you have any questions or concerns about your particular procedure, he or she will be able to answer them for you, setting your mind at ease before, during and after your treatment.

As you move forward along your treatment path, continue to educate yourself about your condition and any procedures you have scheduled. Self-education is a powerful way to set your mind at ease throughout the process. The more informed you are as a patient, the more active role you can play in your care, giving you confidence and calmness and allowing your energy to be channeled towards the recovery process.