Supratentorial craniotomy [Neurosurgery Wiki]

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====== Supratentorial craniotomy ======

For supratentorial [[craniotomy]], surgical access, and closure technique, including placement of subgaleal drains, may vary considerably.

[[Bifrontal craniotomy]]

[[Frontal craniotomy]]

[[Pterional craniotomy]]

[[Orbitozygomatic craniotomy]]

[[Supraorbital craniotomy]]

[[Temporal craniotomy]]....


The incidence of [[seizure]]s following supratentorial [[craniotomy]] for non-traumatic pathology has been estimated to be between 15% to 20%; however, the risk of experiencing a seizure may vary from 3% to 92% over a five-year period. Postoperative seizures can precipitate the development of [[epilepsy]]; seizures are most likely to occur within the first month of cranial surgery. The use of [[antiepileptic drug]]s (AEDs) administered pre- or postoperatively to prevent seizures following cranial surgery has been investigated in a number of [[randomised]] [[controlled trial]]s (RCTs).

There is little evidence to suggest that AED treatment administered prophylactically is effective or not effective in preventing post-craniotomy seizures
((Pulman J, Greenhalgh J, Marson AG. Antiepileptic drugs as prophylaxis for
post-craniotomy seizures. Cochrane Database Syst Rev. 2013 Feb 28;(2):CD007286.
doi: 10.1002/14651858.CD007286.pub2. Review. Update in: Cochrane Database Syst
Rev. 2015;(3):CD007286. PubMed PMID: 23450575.
)).

The current evidence base is limited due to the differing methodologies employed in the trials and inconsistencies in reporting of outcomes. Further evidence from good-quality, contemporary trials is required in order to assess the effectiveness of prophylactic AED treatment compared to control groups or other AEDs in preventing post-craniotomy seizures properly
((Weston J, Greenhalgh J, Marson AG. Antiepileptic drugs as prophylaxis for
post-craniotomy seizures. Cochrane Database Syst Rev. 2015 Mar 4;(3):CD007286.
doi: 10.1002/14651858.CD007286.pub3. Review. PubMed PMID: 25738821.)).