Craniotomy vs. craniectomy: What’s the difference?

A craniotomy and a craniectomy are surgical procedures used to treat conditions in the brain. They are both performed by neurosurgeons.

Their names may sound similar, but the two procedures serve different purposes. Here, I’ll explain the differences between a craniotomy and a craniectomy.

How is a craniotomy different from a craniectomy?

First, let's get to the root of each word to help you understand the difference between a craniotomy and a craniectomy.

Craniotomy

‘Crani-‘ refers to the skull. The suffix ‘otomy’ – is a derivative of the Greek ‘-tomia,’ which means ‘to cut.’ So, craniotomy means, by definition, to cut the bone.

During a craniotomy, the neurosurgeon cuts through the skull to release and elevate a piece of the skull. This allows them to access tumors in the brain.

After removing the tumor, the surgeon puts the piece of bone back in place, securing it with small screws and plates.

Craniectomy

Again, ‘crani-‘ refers to the skull, but ‘-ectomy’ means ‘to cut out.’ So, craniectomy means to cut out the bone.

Much like a craniotomy, when performing a craniectomy, the neurosurgeon removes part of the skull to get to the brain. But they don’t replace it. Often, at a later date, the neurosurgeon replaces the removed bone with an artificial mesh or another material. This second procedure is known as a cranioplasty.   

Why would you need a craniotomy?

A craniotomy is the most common surgery to treat brain tumors. We perform craniotomies so we can get to the brain and surgically remove the tumor.

A craniotomy is also used to treat other types of brain lesions, such as:

• aneurysms,
• arteriovenous malformations and
• hematomas, non-cancerous collections of blood in the brain.

Why would you need a craniectomy?

Craniectomies are most commonly done to relieve pressure due to swelling in the brain caused by:

• stroke,
• brain bleeding or
• traumatic brain injury.

At MD Anderson, we rarely need to perform craniectomies because most of the time we can control swelling in the brain when we remove brain tumors.

What is the recovery time for a craniotomy and a craniectomy?

The time it takes to recover from a craniotomy or a craniectomy depends on what we do to the brain and the complexity of the surgery.

Most patients spend anywhere from a few days to two weeks in the hospital after a craniotomy or craniectomy.

Some brain tumor patients can resume normal activities fairly quickly once they return home; for others, it may take longer. It could take several months to heal from a craniotomy or craniectomy fully. It depends on your situation.  

Your doctor will talk to you about what to expect during recovery and answer any questions you may have.

Frederick Lang, M.D., is a neurosurgeon and chair of Neurosurgery at MD Anderson.

Request an appointment at MD Anderson online or call 1-877-632-6789.