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A craniotomy involves surgically removing a portion of the skull to access the brain. During this procedure, specialized instruments are used to extract a section of bone, known as the bone flap. This bone flap is temporarily removed and reattached.
Some craniotomy procedures incorporate computer and imaging technologies, such as magnetic resonance imaging (MRI) or computerized tomography (CT) scans, to accurately target the specific brain area needing treatment. This advanced technique may involve the use of a frame fixed to the skull or a frameless system with surface markers or landmarks on the scalp. When these imaging methods are used in conjunction with the craniotomy, the procedure is referred to as a stereotactic craniotomy.
Types of Craniotomy:
- Extended Bifrontal Craniotomy: It is a traditional skull base approach involving an incision behind the hairline and removal of forehead and orbital bone to safely access front brain tumors, such as meningiomas, esthesioneuroblastomas, and malignant skull base tumors, without unnecessary brain manipulation. This technique is used when minimally invasive methods are unsuitable.
- Minimally Invasive Supra-Orbital “Eyebrow” Craniotomy: Supra-orbital craniotomy, also known as "eyebrow" craniotomy, is a method to remove brain tumors via a small incision above the eyebrow, particularly for tumors near the pituitary gland or optic nerves, substituting endonasal endoscopic surgery for large or critical cases.
- Retro-Sigmoid “Keyhole” Craniotomy: It is also known as "keyhole" craniotomy, is a minimally-invasive procedure for removing brain tumors via a small incision behind the ear, facilitating access to the cerebellum and brainstem, particularly useful for tumors like meningiomas, acoustic neuromas, skull base tumors, and metastatic brain tumors, offering benefits such as reduced postoperative pain, minimal scarring, and quicker recovery compared to open craniotomies.
- Orbitozygomatic Craniotomy: It is a traditional skull base approach, that involves removing bone around the orbit and cheek to access complex brain tumors and aneurysms, minimizing brain manipulation and enabling deeper surgical reach.
Elective craniotomies are performed to gain brain access for various non-emergency indications, including tumor resection, aneurysm clipping, AVM repair, epilepsy surgery, or DBS. The target is to address neurological pathologies that are not immediately life-threatening but cause progressive malfunctioning or long-term disability potential.
There is a need for neurological evaluation if a patient presents with persistent headache, seizure, focal neurological deficit (weakness, vision changes, or speech difficulties), or cognitive decline. A space-occupying lesion or vascular anomaly on imaging (MRI or CT) usually places the patient under elective neurosurgical consultation.
The preoperative preparation phase includes neuroimaging (MRI, MR angiography, or functional MRI), neuropsychological testing, and medical checkup (electrocardiogram, laboratory tests, and anesthesia evaluation). Under supervision, anticoagulants and antiplatelet agents are stopped. Patient education about what to expect during and after the procedure, informed consent regarding the risks, and the recovery process are also necessary.
The term craniotomy refers to the removal of the skull to access the brain directly. Under general anaesthesia, a tailored skin incision and bone flap are made to locate the lesion. Intraoperative neuronavigation and electrophysiological monitoring can increase the procedure's precision and prevent collateral damage. Finally, the bone flap is fixed, and the skin incision is sutured.
It is widely variable, sometimes highly depending on the indication for surgery or the case's complexity. Removing a simple tumour generally takes 3-4 hours, but it can take 6-8 hours or even more for complex cases such as AVM excision or functional mapping.
- Hemorrhage
- Infection (e.g., meningitis)
- Cerebral edema
- Seizures
- Cerebrospinal fluid leak
- Stroke
- Neurological deficits (temporary or permanent)
Elective craniotomies performed correctly provide significant opportunities for reducing tumor burden, alleviating neurological symptoms, preventing hemorrhagic events, and improving quality of life. Considerable symptom control and reduced dependency on medications may also be achieved in certain instances of epilepsy surgery and DBS.
Initial postoperative recovery includes ICU monitoring for the first 24 to 48 hours and then transfer to the neurosurgical ward. Most patients are discharged within 5 to 10 days, and complete functional recovery depends on the type of surgery and the patient's preoperative condition. Rehabilitation-physical, occupational, or speech therapies-may be needed. Following this, postoperative imaging is carried out to verify the surgical results.
The success rates depend on the surgical indication but are generally high for elective cases. Removal of tumors can have around 80 to 90% success in relieving symptoms or controlling the disease. Functional operations such as DBS or epilepsy surgery show significant improvement in 60–85% of cases in appropriately selected patients.
Top Selling Packages for Craniotomy
Deep Tumor Craniotomy
Amrita Hospital, Faridabad, India
USD 7500 USD 8000
Craniotomy with Excision of Tumour
Sanar International Hospital, Gurugram, India
USD 6500 USD 7800
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NMC As Salama Hospital
Al Khobar, Saudi Arabia
Apart from in-detail treatment procedures available, NMC As Salama Hospital located in Al Khobar, Saudi Arabia has a wide variety of facilities available for International Patients. Some of the facilities which are provided by them are Accommodation, Airport Transfer, Choice of Meals, Interpreter, SIM, TV inside room. Also listed below are some of the most prominent infrastructural details:
- Technology Advancement- Hospital has an ultrasound unit, a mammogram, a CT scan unit, and an X-ray imaging unit
- Laboratory
- 60 Private bedrooms
- Operating rooms
- Labor and Delivery Units
- Isolation rooms
- 2 Dental clinics
- Special Care Units
- 24*7 Emergency Services
- Intensive Care Unit
- Pharmacy
- Cafeteria
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+99Process Involved for Craniotomy in Al Khobar
- Pre-Surgical Preparation: Imaging studies of the brain (CT, MRI, angiogram), blood work, and anesthesia evaluation to assess risk and plan the procedure.
- Surgery Pathway: A scalp incision is made, the bone flap is removed, and the procedure (tumor removal, aneurysm repair, hemorrhage evacuation) is performed.
- Post-Surgical Recovery: Monitoring in the ICU, pain management, and rehabilitation (physical/speech therapy) initiate recovery that allows gradual return to activities.
It is recommended for individuals with:
- Brain tumor
- Traumatic Brain Injury (TBI)
- Aneurysms & Arteriovenous Malformations (AVMs)
- Epilepsy Surgery
- Hydrocephalus
- Brain Abscess or Infection
- Parkinson's Disease or Movement Disorders
- Stereotactic Brain Surgery
- Shunt Placement
- Deep Brain Stimulation (DBS)
- Endovascular Procedures
- It treats life-threatening brain conditions, such as tumors, hemorrhages, and aneurysms.
- It reduces brain pressure and preserves neurological function.
- Improves seizure control and movement disorders in selected cases.
- Excellent enhancement of overall brain function and quality of life after successful treatment.
- Neurosurgeon
- Neurologist
- Rehabilitation Specialist
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