Which statement best differentiates craniectomy from craniotomy?

Which statement best differentiates craniectomy from craniotomy?

• A. Craniectomy removes skull portion and is not replaced; craniotomy skull is replaced
• B. Craniectomy and craniotomy are the same procedure
• C. Craniectomy always includes shunting CSF
• D. Craniotomy removes skull portion and is never replaced

Answer: (A)

The key idea is how the skull bone is handled during the procedure. In a craniectomy, a portion of the skull is removed to relieve pressure or swelling, and that bone is not replaced during the same operation (often it may be stored for a later cranioplasty). In a craniotomy, you open the skull to access the brain, but the bone flap is replaced at the end of the procedure, sometimes with fixation. This distinction—bone removal without immediate replacement versus bone flap replacement after the operation—best differentiates the two procedures. The other statements aren’t accurate defining features: craniectomy doesn’t always involve CSF shunting, and craniotomy typically does involve replacing the bone, not never replacing it.

The key idea is how the skull bone is handled during the procedure. In a craniectomy, a portion of the skull is removed to relieve pressure or swelling, and that bone is not replaced during the same operation (often it may be stored for a later cranioplasty). In a craniotomy, you open the skull to access the brain, but the bone flap is replaced at the end of the procedure, sometimes with fixation.

This distinction—bone removal without immediate replacement versus bone flap replacement after the operation—best differentiates the two procedures. The other statements aren’t accurate defining features: craniectomy doesn’t always involve CSF shunting, and craniotomy typically does involve replacing the bone, not never replacing it.