Craniotomies can be classified based on anatomical location, surgical approach, indication, and technical considerations.
| Region | Common Indications |
|---|---|
| Frontal craniotomy | Tumors, trauma, abscess, epilepsy, frontal sinus |
| Temporal | Epilepsy surgery, mesial temporal sclerosis, tumors |
| Parietal | Tumors, AVMs, metastases, cortical mapping |
| Occipital | Tumors, AVMs, visual cortex lesions |
| Pterional | Aneurysms, skull base tumors, MCA/ICA lesions |
| Subtemporal | Petroclival tumors, mesial temporal lobe access |
| Orbitozygomatic | Skull base lesions, aneurysms, craniopharyngiomas |
| Retrosigmoid | Acoustic neuromas, posterior fossa tumors |
| Suboccipital | Chiari malformation, posterior fossa tumors |
| Transpetrosal | Clival and petroclival pathology |
| Approach Type | Description |
|---|---|
| Standard craniotomy | Bone flap removed and replaced after surgery |
| Keyhole craniotomy | Minimally invasive, small access (e.g., eyebrow) |
| Extended approaches | Combined or large exposures (e.g., OZ + pterional) |
| Endoscopic-assisted | With or without bone flap, skull base procedures |
| Awake craniotomy | Functional mapping in conscious patients |
| Indication | Example Craniotomies |
|---|---|
| Tumor | Frontal, parietal, pterional, suboccipital |
| Vascular | Pterional, orbitozygomatic, occipital, parasagittal |
| Epilepsy | Temporal lobectomy, frontal lobe resection |
| Trauma | Decompressive hemicraniectomy, bifrontal |
| Infection/Abscess | Frontal, parietal |
| Chiari Malformation | Suboccipital midline decompression |
| Type | Characteristics |
|---|---|
| Decompressive craniectomy | Bone not replaced; used in severe trauma/stroke |
| Craniotomy with duraplasty | Dural expansion using graft |
| Burr hole craniotomy | For hematomas or catheter insertion (e.g., EVD) |