Pediatric Endoscopic Craniotomy

What is an endoscopic craniotomy?

A craniotomy is a type of brain surgery. During a traditional craniotomy, a neurosurgeon removes a piece of the skull to access the brain. But in some cases, the neurosurgeon can perform an endoscopic craniotomy instead. For this, the surgeon makes a small hole in the skull and inserts an endoscope – a thin tube with a light and tiny camera on the end. The surgeon passes tools through the endoscope to operate on the brain. This procedure is also called a minimally invasive or "keyhole" craniotomy due to the smaller opening in the skull.

To make craniotomies and other brain procedures more precise, UCSF neurosurgeons use the most advanced imaging tools available. These include brain mapping, neuronavigation systems (which give the surgeon a customized map of the patient's brain before surgery), and CT or MRI scanning during surgery.

Are other minimally invasive brain surgery techniques available?

In some cases, surgeons can use a different minimally invasive approach in which they insert endoscopes and other tools through the nasal passages and sinuses. This eliminates the need to make any opening in the skull. Often, a neurosurgeon and an otolaryngologist (an ear, nose and throat specialist) perform these procedures together.

This technique may be used to remove tumors located at the base of the skull or in the sinuses around the nose. In the past, some tumors in these locations were impossible to remove surgically or required an open (traditional) craniotomy.

What are the benefits of minimally invasive brain surgery?

Minimally invasive surgery has several advantages over traditional surgery, including:

• A lower risk of complications
• Shorter hospital stays
• Less scarring

What are craniotomies used to treat?

Craniotomies are used for a variety of neurological conditions, such as:

• Aneurysms
• Arteriovenous malformations (abnormal tangles of blood vessels in the brain)
• Blood clots in the brain
• Brain tumors
• Epilepsy
• Hydrocephalus

What are the risks of brain surgery?

Any type of surgery has risks. Possible complications of brain surgery include:

• Temporary or permanent problems with functions controlled by the brain, such as speech, memory, movement or vision
• Bleeding in the brain
• Stroke
• Brain swelling
• Infection
• Seizures

How should I prepare for my child's brain surgery?

The pediatric neurosurgery team will walk you through what to expect on the day of your child's procedure and the days that follow. We want your family to be as informed and comfortable as possible, so please ask any questions you have.

You may be asked to wash your child's hair with a special shampoo the night before the procedure. Learn more about how to prepare for your child's surgery.

After the surgery, our team will carefully monitor your child to make sure they are recovering well.

Before your child goes home, the team will meet with your family to go over the recovery process and home care instructions. Your child may be referred to physical therapy or other services to help with their recovery.