Kraniotomi

Kraniotomi, or craniotomy, is a neurosurgical procedure in which a portion of the skull is removed to access the brain or intracranial structures. After the operation, the bone flap is typically replaced and fixed in place. The term distinguishes craniotomy from craniectomy, in which the bone is removed and left off during the initial procedure, often to mitigate brain swelling, with reconstructive surgery (cranioplasty) performed later.

Indications include removal of brain tumors, clipping or bypass of intracranial aneurysms or vascular malformations, evacuation of hematomas (epidural, subdural, intracerebral), treatment of intracranial infections or abscesses, relief of raised intracranial pressure after trauma or stroke, and certain epilepsy surgeries.

Procedure involves preoperative planning with imaging, general anesthesia, and sterile exposure. A bone flap (a section of the skull) is shaped and removed to access the brain. The dura is opened to reach the pathology, which is then addressed. The dura is closed, and the skull bone flap is replaced and secured with plates and screws. In some cases, a cranioplasty may be performed later if the bone is not used or replaced.

Risks include infection, bleeding, neurologic deficits, seizures, CSF leaks, and brain swelling. Recovery varies with pathology and extent of surgery and may involve intensive care, imaging, and multidisciplinary rehabilitation.

Craniotomy has evolved with advances in imaging, microsurgical technique, and perioperative care, supporting a wide range of intracranial interventions.