Like any other part of the body, the brain is susceptible to bleeding, infection, trauma and other forms of damage. This damage or alteration in brain function sometimes requires brain surgery to diagnose or treat these problems. A craniotomy is an operation to open the skull (cranium) in order to access the brain for surgical repair. There are many different types of brain surgery, but the recovery process following craniotomy is much the same in most cases.

Conditions requiring a craniotomy

Some of the conditions that require craniotomy and surgical repair include:
Brain cancers
Infections
Abscesses
Cerebral oedema (swelling of the brain)
Bleeding within the skull.

Procedure for a craniotomy

The general procedure for craniotomy includes the following steps. The hair on your scalp is shaved.
You are given a general anaesthetic.
Your head is placed on a round or horseshoe-shaped headrest so that the area where the brain injury is thought to lie is easily accessible. If head movement must be minimized, your head is clamped into place with a head pin fixing device.
Through preoperative imaging, the neurosurgeon determines the most appropriate site for the craniotomy. The procedure begins by first cutting through the scalp.
Small holes (burr holes) are drilled into the exposed skull with an instrument called a perforator.
An instrument called a craniotomy is used to cut from one burr hole to the next, creating a removable bone flap.
The membrane covering the brain is opened, usually as a flap.
The brain injury or disease is operated on – for example, ruptured blood vessels are repaired, or the blood clot or tumour is removed.
After the operation is finished, the piece of excised bone is replaced, the muscle and skin are stitched up and a drain is placed inside the brain to remove any excess blood left from the surgery.
A craniotomy can take about two and a half hours.