A craniotomy is a surgical procedure to open the skull. A part of the skull, called a bone flap, is removed to gain access to the brain for other procedures. In most cases, the bone flap is replaced after the procedure is finished. Craniotomies vary in size depending on what the problem is.

A craniotomy is any surgical opening into the skull, but it can also be named for the type of procedure that needs to be done, or how it is carried out. Other craniotomies types may include:

  • Burr hole or keyhole—a small, dime-sized hole is made in the bone of the skull
  • Awake—once the bone in the skull is opened, you are awakened from anesthesia
  • Stereotactic—computer navigation is used take images of the problem area, which then guide the surgeon to the precise location in the brain through one or more burr holes
  • Endoscopic—a lighted scope with a camera is inserted into the brain through one or more burr holes

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The type of procedure depends on the reason it is being done. The most common reasons for a craniotomy include:

  • Biopsy
  • Brain cancer
  • Head trauma
  • Blood clot in the brain
  • Blood vessel problems with the brain
  • Nerve disorders
  • Brain swelling
  • Brain infection
  • Hydrocephalus treatment—insertion of a ventriculoperitoneal shunt which allows excess cerebrospinal fluid to drain into another area, usually the abdomen

Smoking may increase the risk of complications.