Craniotomy

January 12, 2026

This page was reviewed under our medical and editorial policy by Rosalind Munoz, P.A., Department of Medical Oncology & Therapeutics Research, City of Hope^® Cancer Center Duarte.

A craniotomy is the most common surgical procedure used to treat brain tumors. During a craniotomy, neurosurgeons make an opening in the skull, which allows them to reach a tumor in order to remove it or treat it more effectively. A craniotomy may be necessary if a patient has to undergo procedures such as stereotactic biopsy, stereotactic aspiration or stereotactic radiosurgery. Some common brain tumors that may be treated by a craniotomy include:

• Cerebellopontine angle tumor
• Meningioma
• Epidermoid cysts
• Epydemoma
• Glioma
• Oligodendroglioma
• Orbital tumors
• Sellar and parasellar tumors

What Is a Craniotomy?

During a craniotomy, expert neurosurgeons remove a section of bone from the skull to expose the brain. This provides access to the brain and allows them to treat or remove a brain tumor. Once treatment is complete, the section of bone – also called a bone flap – is fixed back in place, often using metal screws, and the skin is stitched closed over it.

Depending on the size and location of the brain tumor, cancer surgeons may also use imaging techniques such as magnetic resonance imaging or computed tomography to help guide the procedure. This may be referred to as a stereotactic craniotomy.

Craniotomy vs. Craniectomy

Another procedure that is sometimes used to treat brain tumors is a craniectomy. The main difference between a craniotomy and a craniectomy is that, during a craniectomy, the bone flap isn’t replaced after the procedure. Instead, it’s stored safely so that it can be replaced later (a procedure called a cranioplasty). A craniectomy may be recommended for patients whose brain tumors have caused dangerous swelling or buildup of fluid in the brain.

Types of Craniotomy

There are different types of craniotomy, named for the area of the skull that is removed during the procedure. A craniotomy may be performed under general anesthesia, meaning the patient is fully unconscious, or while the patient is awake.

An awake craniotomy is sometimes recommended if a tumor is in a sensitive area of the brain that controls functions such as language. The patient is sedated for the initial removal of the bone flap, then woken so that they can respond to questions or perform tasks during the procedure. This helps surgeons avoid damage to the sensitive areas around the tumor. The type of craniotomy a patient undergoes – and the type of anesthesia that is used – depends on factors such as the location and size of the brain tumor.

• Bifrontal craniotomy is the removal of both sides of the skull bone behind the hairline. It allows surgeons access to the brain tissue that is behind and between the eyes.
• Supraorbital, or “eyebrow,” craniotomy is a more minimally invasive approach that involves making an incision in or around the eyebrow in order to access tumors in the front of the brain or around the pituitary gland.
• Pterional, or frontotemporal, craniotomy is the removal of skull bone near the pterion, which is the point on the side of the skull where the four main skull bones meet. It provides access to several different areas of the brain.
• Middle Fossa craniotomy is the removal of the skull bone near the ear, usually to allow access to the auditory canal. It is most often used to remove acoustic neuroma tumors.
• Keyhole or retrosigmoid craniotomy is a minimally invasive option that removes a small amount of skull bone near the ear. It can be used to remove a variety of brain tumors, including meningioma and skull base tumors.
• Suboccipital craniotomy involves removing skull bone at the base of the skull, allowing surgeons access to a part of the brain called the posterior fossa.
• Far lateral approach craniotomies allow surgeons to access the craniocervical junction, an area at the back of the skull where the brain meets the spine.
• Orbitozygomatic craniotomy is the removal of bone from the top of the skull running down part of the cheek. This enables surgeons to access deeper parts of the brain while causing less damage to critical brain functions.

How Long Does a Craniotomy Take?

A craniotomy usually takes between 4 and 6 hours to complete, including preparation for the surgery and the initial recovery.

Recovery After Surgery

Most patients stay in the hospital for 3 to 7 days after undergoing a craniotomy. During this time, expert nurses and doctors will monitor a patient’s recovery and prescribe any necessary medications, such as pain relievers or antibiotics. It isn’t uncommon for patients to receive fluids or oxygen for several days.

After returning home, patients may experience discomfort or pain at the site of the surgery, as well as headaches. Many people need more rest than usual. It’s important to follow all instructions related to caring for the wound and returning to normal activity and to take any prescribed medications exactly as recommended. Patients will have regular follow-up appointments with their care team, which may include scans and tests to ensure the surgery was successful.

What to Expect with Craniotomy Scar Healing

The bone flap that’s replaced during a craniotomy can take 6 to 12 months to fully heal back into place. During this time, some patients may hear or sense a clicking sound, but this is normal and means the bone flap is healing. Some people will have bumps or uneven spots around the edges of the wound, even after it has fully healed.

Does Hair Grow Back After a Craniotomy?

Yes, hair will grow back after a craniotomy. In most cases, only a small patch of hair needs to be shaved before the procedure. This hair will regrow during the healing process.

Side Effects of Surgery

Craniotomy is a major brain surgery. Like any surgical procedure, there are some risks and possible side effects, including:

• Blood clots or bleeding during or after the procedure
• Infection at the site of the surgery or in the brain tissue
• Pain, numbness or swelling at the site of the surgery
• Problems with brain function that may be temporary or permanent, including changes to speech, memory, senses or movement
• Seizures or stroke
• Swellings or buildup of fluid in the brain
• Problems chewing, if the muscle that controls this function is cut during surgery