title: Midline suboccipital osteoplastic craniotomy - 'cobra craniotomy'.
abstract: BACKGROUND
  Midline suboccipital craniotomy has been proposed as an alternative to conventional craniectomy for removal of posterior fossa tumors.
  
  
  METHODS
  We describe a modified technique for midline suboccipital osteoplastic craniotomy based on the atlantooccipital membrane for a 17-year-old boy with superior vermian astrocytoma. Osteoplastic craniotomy was performed safely in this patient.
  
  
  RESULTS
  The presence of the turned down, attached bone flap did not interfere with surgery. Reattachment of the bone flap was easy and stable. This technique was not associated with additional risks.
  
  
  CONCLUSIONS
  Midline suboccipital osteoplastic craniotomy is a better option for superiorly placed midline posterior fossa tumor surgery.
authors.affiliation: Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore, India.
authors.forename: Tanmoy
authors.initials: T
authors.lastname: Maiti
authors.forename: Dhananjaya I
authors.initials: DI
authors.lastname: Bhat
authors.forename: Bhagavatula Indira
authors.initials: BI
authors.lastname: Devi
authors.forename: Dhaval
authors.initials: D
authors.lastname: Shukla
mesh_terms: D000293:Adolescent; D001254:Astrocytoma / Q000175:diagnosis / Q000601:surgery*; D003399:Craniotomy / Q000379:methods*; D006801:Humans; D015192:Infratentorial Neoplasms / Q000175:diagnosis / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D009777:Occipital Bone / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013524:Surgical Flaps; D014057:Tomography, X-Ray Computed