Related Experiment Video
Updated: Nov 7, 2025
Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment
Published on: September 25, 2009
The Mayfield Skull Clamp: A Literature Review of Its Complications and Technical Nuances for Application
Dieter Thijs1, Tomas Menovsky1
1Department of Neurosurgery, Antwerp University Hospital, Edegem, Belgium.
Insights
The Mayfield skull clamp, a common neurosurgical device, can cause serious complications like vascular injury and skull fractures. Careful application and attention to anatomy are crucial to prevent patient harm.
Area of Science:
- Neurosurgery
- Medical Devices
- Patient Safety
Background:
- The Mayfield skull clamp is a widely used 3-pin head immobilization device in neurosurgery.
- Current guidelines for its application are lacking, despite its association with serious complications.
- This study addresses the need for understanding and preventing Mayfield clamp-related adverse events.
Purpose of the Study:
- To provide an overview of complications associated with the Mayfield skull clamp.
- To present a framework for the correct application of the Mayfield clamp to avoid common issues.
- To enhance neurosurgical safety by detailing potential risks and mitigation strategies.
Main Methods:
- A systematic literature search was conducted on PubMed for articles published between 1980 and 2020.
- Search terms included "Mayfield skull clamp" and "Mayfield head clamp."
- Articles were selected based on English abstracts and clearly attributed complications; cross-references were also reviewed.
Main Results:
- The most frequent complications involved vascular injury from pins and skull fractures.
- While rare, complications associated with the Mayfield clamp can be severe and preventable.
- A conceptual framework for avoiding these complications was developed.
Conclusions:
- Meticulous attention to detail, anatomical knowledge, and the principle of "primum non nocere" are essential during Mayfield clamp placement.
- Thoughtful application, considering specific nuances, is recommended to prevent inadvertent patient harm.
- Adherence to best practices in Mayfield clamp use can significantly improve patient outcomes.
Background:
The Mayfield skull clamp is the most commonly used 3-pin head immobilization device. It is routinely used in cranial neurosurgical procedures and selected cervical procedures. Despite its role in some serious complications, guidelines and nuances on the correct application of the Mayfield clamp are lacking. The goal of this article was to present an overview of the complications associated with the Mayfield skull clamp. We also present a conceptual framework of the correct use-in our opinion-of the Mayfield clamp in several standard approaches to avoid the most common complications.
Methods:
PubMed was searched for original articles published between 1980 and 2020 with the search terms "Mayfield skull clamp" and "Mayfield head clamp." Eligibility criteria were availability of English abstract and complications clearly attributed to the Mayfield skull clamp. Both authors assessed all search results for eligibility. Additional articles were found with cross-references.
Results:
The most common complications associated with Mayfield clamp application were due to vascular injury inflicted by the pins or skull fractures. Complications related to use of the Mayfield clamp were rare but often serious and avoidable. A conceptual framework was presented on how to avoid these complications.
Conclusions:
Attention to detail, anatomy, and the primum non nocere principle are imperative in every step of the neurosurgical pathway, including placement of the Mayfield skull clamp. Thoughtful application, taking into consideration several nuances, is recommended to avoid inadvertent patient harm.
