Keyhole Craniotomy

Minimally invasive “keyhole” and conventional approaches are used to remove tumors over the surface of the brain or within the brain. Technical advances over the last two decades have allowed these approaches to become smaller, safer and more precise. Larger craniotomies are used when the tumor itself is very large and close to the brain surface, while smaller keyhole openings can be used for smaller surface tumors and most deeper tumors regardless of size.

For both keyhole and conventional craniotomies, a preoperative surgical navigation MRI or CT scan allows the scalp incision and bone opening to be tailored to the tumor location and facilitates safe and effective removal. Functional MRI and/or MRI tractography may also be used to determine the relationship of the tumor to critical brain regions and white matter tracts. Intra-operative ultrasound is also often used to help precisely localize deeply situated brain tumors.