In order to access the tissues and vital portions of the brain and treat a neurological condition, disease or disorder, often a surgeon will be required to perform a craniotomy. This procedure involves removing a section of the skull (a “bone flap”) from a location on the head determined by what condition or disorder requires attention.

Craniotomies are utilized for a variety of conditions requiring surgery: for patients suffering from arteriovenous malformations, a craniotomy is necessary to remove a knot of malformed or otherwise abnormal blood vessels that are likely to bleed and therefore can be life threatening; for aneurysms—weak sections of blood vessels that can bleed and rupture—that cannot be treated with coil embolization performed through the femoral artery; for abscesses within the skull that require draining; for the removal of blood clots, such as those that form after head injuries and traumas to the brain; and for tumors that need to removed be as they are impacting the normal functioning of the brain.

While under general anesthesia, a patient’s head is secured to prevent movement during the craniotomy. A surgeon begins by making an incision and pushes away skin and muscle structures. One or possibly more small holes are drilled into the bone of the skull, and a saw is used to cut between the holes and remove a section known as the bone flap. The outermost membrane covering the brain—the dura—is now visible and accessible, and the surgeon cuts through this layer to reach the brain itself and treat whatever condition or disorder required by the surgery.

Afterwards, the dura is closed and the bone flap is returned to its original position and secured in place by plates and screws, and the skin is restored and sutured or stapled shut.

Post-craniotomy, a patient will typically be taken to an intensive care unit for monitoring and recovery from anesthesia. Once the patient is awake, physicians will check for normal breathing ability and that body movements are intact, and that there are no physical or mental complications as result of the surgery. A hospital stay can range from one or two days to weeks depending on the severity of the neurological condition and complexity of the surgery performed for that condition.