Craniectomy

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A craniectomy is a common neurosurgical procedure in which a portion of the skull is resected, but not put back (cf. craniotomy in which the bone flap is re-attached to the surgical defect) . The defect is usually covered over with a skin flap. If the defect is closed by a prosthetic covering then it is known as a cranioplasty.

Indications

Craniectomies are frequently performed to decompress the intracranial contents in patients with elevated intracranial pressures , in which case they might be termed a decompressive craniectomy.

In particular, a craniectomy is often favored in those requiring posterior fossa surgery to avoid problems of post-operative swelling in this region.

  • elevated intracranial pressure 
    • acute trauma
    • infarction
    • intracranial hemorrhage
  • cranial access for tumor resection
  • resection of infected bone flaps following a previous craniotomy
  • resection of calvarial bone infiltrated by tumor

Complications

Non-specific
  • infections of the surgical site
  • subdural and subgaleal hygromas
Craniectomy-specific