A small modification to a decompressive craniotomy to improve the brain-cranium interface: technical note

One underlying aspect of a decompressive craniotomy is the brain-cranium interface. Due to the high pressure, the brain has the tendency to mushroom and squeeze the brain tissue at the bony edges of the craniotomy. A small modification to the decompressive craniotomy is described. The inner tabula and part of the diploe are drilled away using a high-speed drill (using either a sharp or a diamond drill) prior to opening the dura while during drilling, the dura is protected with a spatula.