Trauma Craniotomies

A decompressive craniectomy is a surgical procedure whereby a section of the skull is removed in order to alleviate pressure on the brain. The section that is removed is referred to as a bone flap and is carefully stored and replaced once the surgeon is happy that swelling has subsided. This neurosurgical procedure is predominantly performing in patients who have experienced a severe brain trauma that usually shows life threatening symptoms of excessive swelling of the brain or internal bleeding of the brain. It is in such situations where there is a high chance of brain compression and brain death that a trauma craniectomy is performed.

This procedure is generally done in emergency circumstances where the patient is either already in hospital being closely monitored or on their way to hospital following an accident. The patient is placed under general anaesthetic and is closely monitored by the medical team while the surgeon makes an incision on the scalp at the site where the compression is occurring. Small holes are then drilled into the skull. A medical saw is then used to cut between the holes. The bone flap is removed and safely stored in a sterile environment so that it can be replaced at a later stage. Bleeding on the brain can then be controlled and more space is made available for swelling of the brain. The skin is sutured so as to close the wound.

The recovery time for a head trauma can vary from a few months to several years. Rehabilitation is an important part of recovery to regain as much regular brain function as possible. The bone flap that was previously removed and frozen will be replaced a few months after the original surgery after being meticulously checked for bacteria. If it is not cleared for use, a synthetic bone flap will be used.


Dr MJD Jacobsohn qualified in 2007 at the University of Cape Town. He then completed an AO spinal fellowship at the Spinal Unit of Groote Schuur Hospital. He started full time private practice at Mediclinic Vergelegen in 2009 when he joined the established practice of Dr LS Wessels as his associate. A comprehensive range of cranial and spinal neurosurgical pathology are managed by Dr Jacobsohn.


physical address Block 2, Room 9, Mediclinic Vergelegen, Main Road, Somerset West, 7130

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