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Updated: Jul 8, 2026

A Craniotomy Surgery Procedure for Chronic Brain Imaging

A Craniotomy Surgery Procedure for Chronic Brain Imaging

Published on: February 15, 2008

A simple and aesthetically pleasing floating craniotomy: How I do it.

Tianzun Li¹, Qiumeng Li¹, Ji Xia¹

¹Department of Neurosurgery, Daping Hospital, Army Medical University, Chongqing, China.

Acta Neurochirurgica

|March 8, 2026

Summary

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This study presents a bone flap-preserving floating craniotomy technique for controlled decompression and intracranial pressure (ICP) management. The method allows for effective ICP control and preserves cosmesis, offering an alternative to traditional decompressive craniectomy.

Area of Science:

Neurosurgery
Trauma Surgery
Critical Care

Background:

Decompressive craniectomy and cranioplasty are linked to significant patient morbidity.
Bone flap-preserving techniques like floating and hinged craniotomies aid intracranial pressure (ICP) control.
Optimal techniques for traumatic brain injury (TBI) remain debated, despite recent trials on decompressive craniectomy.

Purpose of the Study:

To describe a straightforward floating craniotomy technique.
To evaluate its efficacy in controlled decompression and ICP management.
To highlight its benefits in preserving cosmesis.

Main Methods:

A bone flap-preserving technique using surgeon's knots and adjustable slip knots.
Suture ends are exteriorized for later definitive securing.

Keywords:

Cranioplasty Decompressive craniectomy Floating craniotomy Hinged craniotomy Intracranial hypertension

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Bone flap is secured once elevated ICP resolves.

Main Results:

The technique provides controlled decompression.
Effective intracranial pressure (ICP) management is achieved.
Cosmesis is preserved post-procedure.

Conclusions:

This floating craniotomy is a straightforward technique.
It offers controlled decompression and effective ICP management.
The method preserves patient cosmesis.