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A craniotomy and a craniectomy are surgical procedures used to treat conditions in the brain. They are both performed by neurosurgeons.

Their names may sound similar, but the two procedures serve different purposes. Here, I¡¯ll explain the differences between a craniotomy and a craniectomy.

How is a craniotomy different from a craniectomy?

First, let's get to the root of each word to help you understand the difference between a craniotomy and a craniectomy.

Craniotomy

¡®Crani-¡® refers to the skull. The suffix ¡®otomy¡¯ ¨C is a derivative of the Greek ¡®-tomia,¡¯ which means ¡®to cut.¡¯ So, craniotomy means, by definition, to cut the bone.

During a craniotomy, the neurosurgeon cuts through the skull to release and elevate a piece of the skull. This allows them to access tumors in the brain.

After removing the tumor, the surgeon puts the piece of bone back in place, securing it with small screws and plates.

Craniectomy

Again, ¡®crani-¡® refers to the skull, but ¡®-ectomy¡¯ means ¡®to cut out.¡¯ So, craniectomy means to cut out the bone.

Much like a craniotomy, when performing a craniectomy, the neurosurgeon removes part of the skull to get to the brain. But they don¡¯t replace it. Often, at a later date, the neurosurgeon replaces the removed bone with an artificial mesh or another material. This second procedure is known as a cranioplasty. ??

Why would you need a craniotomy?

A craniotomy is the most common surgery to treat brain tumors. We perform craniotomies so we can get to the brain and surgically remove the tumor.

A craniotomy is also used to treat other types of brain lesions, such as:

• aneurysms,
• arteriovenous malformations and
• hematomas, non-cancerous collections of blood in the brain.

Why would you need a craniectomy?

Craniectomies are most commonly done to relieve pressure due to swelling in the brain caused by:

• stroke,
• brain bleeding or
• traumatic brain injury.

At MD Anderson, we rarely need to perform craniectomies because most of the time we can control swelling in the brain when we remove brain tumors.

What is the recovery time for a craniotomy and a craniectomy?

The time it takes to recover from a craniotomy or a craniectomy depends on what we do to the brain and the complexity of the surgery.

Most patients spend anywhere from a few days to two weeks in the hospital after a craniotomy or craniectomy.

Some brain tumor patients can resume normal activities fairly quickly once they return home; for others, it may take longer. It could take several months to heal from a craniotomy or craniectomy fully. It depends on your situation. ?

Your doctor will talk to you about what to expect during recovery and answer any questions you may have.

, is a neurosurgeon and chair of Neurosurgery at MD Anderson.

or call 1-877-632-6789.

As a child and adolescent psychiatrist in Puerto Rico, I always tell my patients that in any situation, no matter how hard or difficult it is, there¡¯s always something positive that we can learn. Now, I know how true this statement really is.

I learned this first-hand when I started dealing with brain tumors in the summer of 2014 -- first as a relative, then as a friend and finally, as a patient myself. Along the way, I developed more compassion for my own patients and learned the value of a good support system.

Here¡¯s my story.

My father-in-law¡¯s brain tumor

On July 23, 2014, our family received the devastating news that my father-in-law had a brain tumor. It was glioblastoma, a very aggressive type of brain cancer. His neurosurgeon told us that because of the tumor¡¯s location, it was too dangerous to perform surgery in Puerto Rico. He referred us to MD Anderson¡¯s Sujit Prabhu, M.D., for a second opinion.

Less than 24 hours after we reached out, Dr. Prabhu responded. We made an appointment with him and arrived at MD Anderson¡¯s Brain and Spine Center two weeks later.

My father-in-law was scheduled for surgery right away. His craniotomy took place in the BrainSuite?, a special operating room with an integrated MRI, something not all hospitals have. Dr. Prabhu and his team were able to remove most of the tumor, giving my father-in-law a chance to live longer with better quality of life. We were so happy with the surgery that I told my husband, ¡°If I ever get something in my head, I want Dr. Prabhu to be my doctor.¡± Sadly, my father-in-law¡¯s tumor grew back nine months later, and he passed away in August 2015.

My friend¡¯s brain tumor

Fast forward a few years to September 2017. Hurricane Irma hit Puerto Rico, followed quickly by Maria, a Category 5 hurricane that left the whole island without electricity and water.

Then, another disaster struck. Just two weeks after Hurricane Maria made landfall, my best friend called to let me know her husband, Alfredo, was in the intensive care unit with a brain tumor. I could not believe that another person I knew well was going through this.

Alfredo¡¯s neurosurgeon wanted him to be transferred to another facility. I contacted Dr. Prabhu, who helped us get Alfredo transferred to MD Anderson. Alfredo had surgery with Dr. Prabhu in October 2017 and has now fully recovered from his left frontal meningioma.

My own brain tumor diagnosis

I can¡¯t recall when my own brain tumor symptoms really started. Who wouldn¡¯t have headaches after enduring two hurricanes, no electricity or water for months, hours-long lines to get gas and 13 people suddenly living in my house ¡ª all while still working at the hospital and trying to help those who had lost everything? But my best friend thought my symptoms were too similar to Alfredo¡¯s. She insisted I get a brain MRI. After several months, I finally agreed.

On Feb. 1, 2018, I learned I had a left frontal meningioma -- the same type of brain tumor that Alfredo had. I was in complete denial and shock. One of the first people I called was Dr. Prabhu. He was surprised, but his words of encouragement made me feel so much better. Still, the first few days after my diagnosis were hard. I felt completely lost and depressed. I could not believe this was really happening to me.

Help from my support system

One thing that really helped was taking a trip with my husband right after my brain tumor diagnosis. We went to a beach resort in the Dominican Republic, where I had time to think, cry, calm down and finally get some sleep.

I also reached out to another girlfriend who¡¯d been diagnosed with a meningioma. She spent hours talking with me, and her advice and support really made a difference. As a psychiatrist, referring patients to support groups is something I do frequently, but now I truly realize how important these support systems are.

My brain tumor surgery and recovery

My brain surgery took place on March 20. It was very difficult for my husband to sit in the same waiting room for a third time. But prayers from my family and friends helped us both stay focused, calm and optimistic.?

Dr. Prabhu completely removed the tumor during a seven-hour craniotomy. And, because it was a grade I tumor, I didn¡¯t need any additional treatment.

Coping with the side effects of surgery was harder than I thought it would be. I had frequent headaches and felt dizziness and nausea. I also felt like there was a heavy weight on my head. Although I felt depressed, it helped me appreciate the burden that many of my own patients feel.

It took two months for me to start feeling like myself again and return to work. Now, more than six months after my surgery, I feel great, even though I know my recovery continues.

Gratitude for MD Anderson and perspective

Being able to go to MD Anderson was a blessing. I strongly believe that everything happens for a reason. And my experience at MD Anderson has not only given me a second chance at life, but also a better understanding of my own patients. By sharing my story, I hope others realize that no one is alone in this journey.

Request an appointment at MD Anderson online or by calling 1-877-632-6789.

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My brain tumor diagnosis came suddenly. I had no pain, headaches or any kind of warning. On Oct. 3, 2016, I had difficulty conveying my thoughts during a casual conversation at lunch. By 5 p.m., I just didn¡¯t feel right and had difficulty communicating and texting. Our son, a physician, suggested I go to the ER for a CT scan.

My husband and I did just that, and the world changed at 6 p.m. when the radiologist confirmed I had a large brain tumor. We headed to MD Anderson two days later.

My brain tumor surgery

At the MD Anderson Brain and Spine Center, we met with the most amazing and empathetic neurosurgeon, I immediately felt at ease knowing I was getting the best care available. She scheduled a craniotomy for the following Friday.

I had no symptoms, so I went shopping on Saturday and to dinner that night. But on Sunday morning, I awoke confused and weak. We immediately went to the MD Anderson Emergency Center.

After an MRI on Sunday, my surgery was moved up to the next day: Oct. 10. Dr. Ferguson operated on me for 12 hours and removed more than 95% of the brain tumor, which turned out to be glioblastoma.

When I awoke, she told me that she had done her job and that my job was to listen to the therapists, do my therapy and rest. She said my husband was in charge of everything else. I am so lucky to have had his love and support through all of this.

Regaining mobility after my craniotomy

I didn¡¯t feel any pain when I awoke after surgery, but I couldn¡¯t move my right leg or arm. I could only wiggle my right thumb a little bit. Three days later, I was released from the ICU into recovery, then rehab.

The results from that point on were nothing short of miraculous. My days started with speech and cognitive therapy with Jaimie. Then I would do an hour of physical therapy with Liz, Reggie and Hillary, have lunch, and Taylor would start another hour of occupational therapy.

Within a few days, I could move my arm, then leg a little bit. Two weeks after surgery, I was getting my hair done, walking with a walker and writing to-do lists for my husband! Many people wanted to visit me, but my days were so full of therapy and exercise that I refused all requests. Instead, I completely focused on Dr. Ferguson¡¯s orders to listen to my therapists and rest. By Oct. 27, I began walking without the aid of a walker and was soon walking all over the hospital. I even participated in a hospital-wide scavenger hunt!?

The therapists taught me not just to exercise, but the fundamentals of safety as well. They even brought the car to the front door so I could practice getting in and out. I was discharged on Nov. 2 and released from speech therapy, but I continued my occupational and physical therapy as an outpatient. Thank you, Raymond, Lejoe and Shammi!

My amazing doctors, nurses and therapists took excellent care of me and pushed me to get better each day. Their positive attitudes were contagious. Everyone from the receptionists to the car valets were considerate and truly caring.

Soon after discharge, I met with radiation oncologist , and neuro-oncologist Together they planned a six-week regime of radiation and chemotherapy, which I completed just before Christmas.? ?

Life after brain tumor treatment

Today, I am home and fully mobile. Thanks to my therapists, I can even carry my 18-pound, 5-month-old grandson around the house. I continue to do my exercises and feel even better every day. My faith, family and friends are my rock.

While I know everyone¡¯s experience is different, I feel blessed to have never felt bad from surgery, radiation or chemotherapy. I know I have a second chance after my craniotomy, and I look forward to spending time with family and friends every day.

or by calling 1-877-632-6789.