What it is
"Craniotomy" describes the general family of operations where a planned section of skull is temporarily removed to access the brain, the tumor is addressed, and the bone is replaced at the end. The specifics — the size of the opening, the trajectory, the tools used intraoperatively — depend heavily on the tumor's location, size, and the surrounding brain function.
How we tailor the procedure
Neuro-oncology is rarely a one-size-fits-all operation. Factors that shape the plan include:
- Tumor location relative to eloquent cortex (speech, motor, visual areas)
- Imaging characteristics and working diagnosis
- Patient-specific factors — age, general health, goals, and what matters most to them
- Multidisciplinary input from medical oncology, radiation oncology, and pathology
For tumors near eloquent brain regions, an awake craniotomy may be the right approach to map function in real time. For select pituitary and skull base tumors, an endonasal transsphenoidal approach avoids a scalp incision entirely.
Alternatives
Not every brain tumor needs or benefits from surgery. Stereotactic radiosurgery, observation with serial imaging, and medical therapy are appropriate for specific diagnoses and situations. Part of the initial evaluation is figuring out whether surgery is the right tool for this particular problem — and if it isn't, pointing you toward the team that is.