"Craniectomies for the treatment of cranial trauma date back to at least 10,000 BC in the form of trephination, whereby a small circular craniectomy was performed with a stone 2. Evidence of similar procedures has been uncovered during many periods of human history, including ancient Egypt, Greece, and Rome 2."
"An important step is opening the dura. The effectiveness of decompression merely from removal of the bone flap is limited as the dura is quite thick and inelastic allowing for minimal increase in the available intracranial volume 4. When the dura is opened necrotic parenchyma may be resected although this is generally not recommended 4. An intracranial pressure monitor can be introduced at this time 4. The dural defect is then closed using a dural patch (e.g. periosteum, fascia or artificial dural substitute) 4. Finally, the surrounding tissue and skin are repositioned and secured."
Expected headings
"History"
"Typically, a large question mark-shaped incision is performed extending from the ear, up towards the vertex and back down posteriorly; this allows much of the personal and parietal parts of the skull to be accessed while ensuring the facial nerve is preserved. Once the scalp flap is mobilised, a bone flap with a diameter of at least 12 cm is extracted. Additional removal of temporal bone may be necessary for further access to the middle cranial fossa 4."