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 seizures 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 drugs (AEDs) administered pre- or postoperatively to prevent seizures following cranial surgery has been investigated in a number of randomised controlled trials (RCTs).

There is little evidence to suggest that AED treatment administered prophylactically is effective or not effective in preventing post-craniotomy seizures ¹⁾.

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 ²⁾.