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notes of common surgeries of cranium and brain

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Common Surgeries of the Cranium and Brain — Topic Map

Neurosurgical procedures cover several distinct categories. Here's a breakdown of what this topic includes, based on standard surgical references (Bailey & Love's Short Practice of Surgery, Schwartz's Principles of Surgery, Miller's Anesthesia):
  1. Craniotomy - bone flap removal/replacement to access the brain (pterional, frontotemporal, suboccipital approaches) - used for tumor resection, aneurysm clipping, hematoma evacuation
  2. Craniectomy (including Decompressive Craniectomy) - bone removed and NOT replaced immediately, to relieve raised intracranial pressure (trauma, malignant stroke, severe edema)
  3. Burr Hole Surgery - small drill openings for evacuating chronic subdural hematoma, placing ICP monitors/EVDs, or biopsy access
  4. Ventricular Shunt Procedures (VP shunt, EVD) - for hydrocephalus management
  5. Stereotactic and Awake Craniotomy - precision-guided surgery for deep lesions or eloquent-cortex tumors where the patient stays awake for functional mapping
  6. Vascular Neurosurgery - aneurysm clipping, AVM excision, carotid endarterectomy-adjacent procedures, bypass surgery
  7. Tumor Surgery - resection of gliomas, meningiomas, pituitary tumors (often via craniotomy or transsphenoidal approach)
  8. Trauma Surgery - evacuation of extradural/subdural/intracerebral hematomas, depressed skull fracture elevation
  9. Pediatric Neurosurgery - craniosynostosis repair, hydrocephalus shunts, myelomeningocele closure
  10. Spinal/Skull Base adjacent procedures - sometimes grouped with cranial surgery (transsphenoidal, translabyrinthine approaches)
Brief overview: Cranial surgery broadly falls into two intents: decompressive (relieving pressure - craniectomy, burr holes, EVDs, used in trauma/stroke/hydrocephalus) and definitive/therapeutic (removing pathology - craniotomy for tumors, aneurysms, hematomas). The choice of approach depends on lesion location, urgency, and whether the bone flap needs replacing. Anesthetic and positioning considerations (head fixation, ICP control, awake mapping) are integral parts of these procedures in modern practice.
Which of these would you like detailed notes on (indications, steps, complications, imaging)?
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