Concentric craniotomy: removal of tumor involving the skull and the intracranial space.

BACKGROUND

Removal of a tumor involving both the intracranial space and the skull presents technical challenges. This is especially so if there is a potential for significant hemorrhage due to a hemangioma or a significant attachment to the brain as with a meningioma.

CASE DESCRIPTION: We describe a technique where the tumor attached to the skull is left undisturbed and a second wider concentric craniotomy exposes normal dura. The entire tumor, both intracranial and that involving the skull and dura, can then be removed as one specimen.

CONCLUSION

The technique we describe, a concentric craniotomy, transforms a difficult operation with the potential for significant hemorrhage into a more standard removal of a convexity tumor.