Right Frontal Craniotomy
This exhibit depicts a right frontal craniotomy, subdural hematoma evacuation, and skull reconstruction. The procedure begins with a bicoronal scalp incision and removal of small fracture fragments. Larger fragments are then cut away with a drill to create a craniotomy flap. The exposed dura is incised, and damaged interior frontal sinus mucosa is stripped away. Subdural blood is evacuated with suction, and the frontal sinus is cranialized with Tisseel and Gelfoam. Next, the anterior skull base is packed with a harvested piece of temporalis muscle, and Tisseel is laid over the olfactory nerve roots. The bilateral zygomatic bones are then reinforced with struts, the dural incision is closed, and pericranium is sutured over the cranialized frontal sinus. An intracranial pressure monitor and subdural catheter are inserted through separate stab incisions. Skull reconstruction is then completed with plates and screws.