Types of Craniotomy

To reach the precise location for your brain surgery, your neurosurgeon might use computers and advanced imaging, such as MRI or CT scans. This is called stereotactic craniotomy.

Stereotactic craniotomy gives your neurosurgeon a three-dimensional (3D) image of your brain tumor. It tells the surgeon exactly where the tumor is located inside the brain. It also shows the difference between tumor tissue and healthy brain tissue. This helps your neurosurgeon avoid healthy tissue as much as possible.

A stereotactic craniotomy can also be used during a brain biopsy. The imaging scans (CT or MRI scans) show your neurosurgeon where to place a needle to take a sample of tumor tissue. The sample is removed and examined under a microscope.

Stereotactic craniotomy can also guide a needle to remove fluid from abscesses, hematomas (areas where blood collects) or cysts (sacs filled with fluid or other material). It can guide precise beams of radiation used to treat brain tumors.

If you have a stereotactic craniotomy, your head might be placed in a frame or you might have markers placed on your head before surgery. The frame or markers help guide the imaging equipment. Doctors at the OHSU Brain Institute are experts in all types of craniotomy, including stereotactic craniotomy.

An endoscopic craniotomy is another type of craniotomy. It uses a lighted scope (tiny lighted tube) with a camera. This is inserted into the brain through a small incision (opening) in the skull. It allows your neurosurgeon to see much better than he or she could see with the naked eye or special magnifying eyewear.

A craniectomy is similar to a craniotomy. The bone flap (piece of skull removed in surgery) is removed permanently (not put back after surgery). Your neurosurgeon may do a craniectomy if your brain is likely to swell after surgery or if the skull bone flap cannot be replaced for other reasons.