Planning and positioning
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Supine position with the head in neutral position; chin flexed; torso elevated 10 degrees above horizontal
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Transverse, sigmoid incision at coronal suture extending across midline
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Neuronavigation optional but helpful in planning craniotomy flap that ensures access to anterior and posterior callosum, while avoiding large, bridging cortical veins
Figure 40-1:
The patient is positioned supine, with the head flexed in a Mayfield head holder and the torso elevated approximately 10 to 20 degrees above the horizontal. Early use of mannitol and mild hyperventilation minimize frontal lobe retraction during the operation.
Figure 40-2:
After minimal clipping of the hair, a sigmoid incision located over the coronal suture is used.
Figure 40-3:
Frameless navigation may be used to optimize the craniotomy location to avoid cortical veins and plan trajectories to the anterior and posterior aspects of the corpus callosum.
Procedure
