Concierge neurosurgery · London
Craniotomy — brain surgery, explained properly.
A patient guide to craniotomy: the approaches, the indications, awake surgery for eloquent-cortex tumours, image-guided neuronavigation and 5-ALA fluorescence — and the recovery that follows, honestly.
Clinically reviewed by Pulse Atlas Editorial Board, · Updated 2026-07-30 · Next review 2027-07-30 · About a 7-minute read
Why patients choose us
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A consultant neurosurgeon, named
Not a rotating team and not a training list. A named consultant neurosurgeon plans your operation and performs it, from the first image to the last stitch.
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Neuro-oncology, vascular and functional subspecialties
Craniotomy is not one operation. We match you to a surgeon whose subspecialty — tumour, aneurysm, AVM, epilepsy or functional — actually fits your diagnosis.
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Independent, and free
We are paid by no hospital, so the recommendation is impartial and costs you nothing.
Indicative pricing
What a private craniotomy costs in London.
Indicative ranges across our partner hospitals. Send the imaging and we quote firm figures across two or three consultant options.
In short
An elective tumour craniotomy in our network: £28,000–£55,000, hospital stay 3–7 nights.
| Procedure | Indicative range | Theatre time | Hospital stay |
|---|---|---|---|
| Craniotomy for tumour (elective) | £28,000–£55,000 | 4–8 h theatre | 3–7 nights |
| Awake craniotomy (eloquent-cortex tumour) | £35,000–£70,000 | 5–8 h theatre | 3–7 nights |
| Craniotomy for aneurysm clipping | £30,000–£60,000 | 4–7 h theatre | 5–10 nights |
| Craniotomy for AVM resection | £35,000–£70,000 | 5–10 h theatre | 5–10 nights |
| Craniotomy for haematoma evacuation | £20,000–£45,000 | 2–4 h theatre | 3–10 nights |
| Neurosurgical consultation only | £300–£600 | 45 min | Same visit |
Prices vary by hospital, by consultant, by the indication and by the adjuncts used (intraoperative MRI, 5-ALA, cortical mapping, ICU time). We come back with a firm quote after the consultant reviews your imaging.
The problem
The right subspecialty, the right approach, the right hospital.
Craniotomy is not one operation and neurosurgery is not one subspecialty. The consultant who is right for a glioma is not necessarily the one who is right for an aneurysm — we make sure the two are matched properly before you commit.
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Not sure of the diagnosis?
We arrange the imaging and neurosurgical review that turns a scan finding into a plan you can actually act on.
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Worried about the risks?
Awake technique, cortical mapping and 5-ALA fluorescence reduce — not eliminate — the risk. The surgeon quantifies it for your case.
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Want it done in the right hospital?
A named consultant neurosurgeon, a hospital with a neuro-ICU and intraoperative imaging, and a rehab plan on day one.
The journey
From imaging to rehabilitation — what happens, in order.
One clinician and one concierge from first message to follow-up — including the rehabilitation phase.
Phase 1 · Before surgery
Imaging, review and workup
Phase 2 · Surgery and ICU
Theatre, ICU and ward
Phase 3 · Rehab
Home, follow-up, rehab
- 01
Before
You send us the imaging
MRI, CT or angiography reports, and a short summary of symptoms. If you don’t have them yet, we help arrange them.
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Before
Consultant review and plan
Within a working day: the right subspecialty, the right approach (pterional, frontal, temporal, occipital, sub-occipital, retrosigmoid, translabyrinthine), an indicative timeline.
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Before
Workup and pre-assessment
Blood tests, ECG, anaesthetic review. Neuronavigation MRI, functional MRI and tractography where needed. Steroids, anticonvulsants and blood-thinning meds reviewed with the team.
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Surgery
Admission and surgery
Admission the day before or on the morning. Image-guided craniotomy with intraoperative MRI, 5-ALA fluorescence for glioma and cortical mapping where indicated. Awake craniotomy is offered for eloquent-cortex tumours.
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Surgery
Recovery in neuro-ICU
The first 24–48 hours in a neurosurgical ICU or HDU. Regular neurological checks, seizure prophylaxis, imaging as needed.
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After
Ward, discharge and home
Ward stay of typically 3–7 days depending on the indication and recovery. Written aftercare, wound care and a clear plan for driving, work and flying.
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After
Rehabilitation and follow-up
Cognitive, speech and physical rehabilitation where needed. Neuro-oncology or vascular follow-up, further imaging and medication review — coordinated by us.
Typical elective end-to-end: 2–4 weeks from enquiry to surgery. Cognitive recovery: weeks to months.
When it helps
When a craniotomy is the right step.
The situations that most commonly bring patients to a neurosurgeon — plus the red flag that means an emergency rather than an appointment.
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Brain tumour
Glioma, meningioma, metastasis or other intracranial tumour where surgical resection is the right first step.
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Intracranial haematoma
Extradural, subdural or intracerebral bleeding where evacuation is needed to relieve pressure on the brain.
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Cerebral aneurysm
A saccular or complex aneurysm where microsurgical clipping is preferred over endovascular coiling.
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Arteriovenous malformation (AVM)
A tangle of abnormal vessels where microsurgical resection — sometimes with prior embolisation — is planned.
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Drug-resistant epilepsy
Focal epilepsy that has not responded to medication, where resection of a seizure focus can stop or reduce seizures.
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Functional neurosurgery
Deep-brain stimulation, cortical stimulation and other functional procedures for movement disorders and pain.
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Decompressive craniectomy
For malignant swelling after stroke, trauma or infection where opening the skull relieves life-threatening pressure.
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Red flag: rapid deterioration
Sudden severe headache, new weakness, seizure or loss of consciousness is an emergency — 999 and A&E, not a clinic booking.
Approaches
The main craniotomy approaches, in plain English.
The name of the operation usually describes the corridor the surgeon uses to reach the target — chosen to fit the lesion, not the other way around.
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Pterional craniotomy
A classic frontotemporal approach used for anterior circulation aneurysms, sellar and parasellar tumours, and some frontal lesions.
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Frontal / bifrontal craniotomy
For lesions of the frontal lobes, olfactory groove meningiomas and anterior skull base tumours.
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Temporal and parietal craniotomies
For temporal or parietal lobe tumours, mesial temporal epilepsy surgery, and cortical AVMs.
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Occipital and sub-occipital approaches
For posterior fossa tumours, cerebellar lesions and lower cranial nerve pathology.
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Retrosigmoid and translabyrinthine
Lateral skull-base approaches for vestibular schwannoma and other cerebello-pontine angle tumours.
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Awake craniotomy
Used for tumours in or near eloquent cortex — you are awake for the mapping phase so speech and motor function can be tested in real time.
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Endoscope-assisted and keyhole
Smaller openings with endoscopic visualisation, chosen where anatomy and pathology allow a less invasive corridor.
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Decompressive craniectomy
A larger piece of skull is removed and left off to allow swelling — replaced later by cranioplasty once the brain has settled.
Our vetted London network
A small panel of neurosurgeons, we picked them.
Consultant neurosurgeons at central London teaching hospitals with neuro-ICU, intraoperative imaging and 24-hour on-call. Introductions are made privately, once we understand your case.
Selection criteria
How we choose every neurosurgeon in our network.
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Consultant neurosurgeons on the GMC specialist register — not fellows or trainees
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Declared subspecialty in neuro-oncology, vascular or functional neurosurgery
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Hospitals with neurosurgical ICU, intraoperative imaging and 24-hour on-call cover
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Access to awake craniotomy, cortical mapping, 5-ALA fluorescence and neuronavigation
Risks and recovery
What to expect afterwards — honestly.
Craniotomy is a major operation with real, quantifiable risks that depend on the indication and location. The list below is honest, not exhaustive — your surgeon will tell you which apply to your case.
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Haemorrhage
Bleeding into or around the operative site is uncommon but serious. The team monitors for it in ICU and images at the first suspicion.
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Cerebral oedema
Swelling around the operative site is expected — steroids are used routinely and imaging repeated if symptoms change.
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Seizures
Post-operative seizures are more likely with cortical lesions. Anticonvulsant prophylaxis is used selectively based on your risk.
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Infection and meningitis
Wound infection is uncommon; meningitis is rare but taken seriously — fever with headache or stiff neck is always investigated.
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CSF leak
Cerebrospinal fluid can leak from the wound or nose after some approaches. It usually settles, occasionally needs a small further procedure.
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Neurological deficit
New or worse weakness, speech or vision problems are possible, especially with eloquent-cortex surgery. Mapping and awake technique reduce — not eliminate — the risk.
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DVT and pulmonary embolism
Clots in the leg or lung are prevented with early mobilisation, compression and — when safe — chemical prophylaxis.
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Cognitive recovery takes time
Fatigue, word-finding difficulty and slowed thinking are common for weeks and often months. Neuropsychology and rehab help.
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Red flags after discharge
A new severe headache, new weakness or numbness, a seizure, spreading redness at the wound, fever or clear fluid from the nose are reasons to call the team or A&E the same day.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever approach was used, the note the neurosurgeon sends you keeps to the same shape.
A quiet reminder
Neurosurgical language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Indication and approach
Why the craniotomy was done — tumour, haematoma, aneurysm, AVM, epilepsy — and which approach was chosen (pterional, frontal, temporal, sub-occipital, retrosigmoid, translabyrinthine).
- 02 Technique
Neuronavigation, mapping and adjuncts
Whether neuronavigation, intraoperative MRI, 5-ALA fluorescence or cortical mapping were used, and whether the operation was performed awake or asleep.
- 03 Findings
Extent of resection and complications
What was found, how much was removed or clipped, and any intra-operative events. For tumours, the surgeon’s impression of extent — confirmed later on post-op MRI and histology.
- 04 Impression
ICU plan, seizure prophylaxis, rehab
Read this first: the plan for ICU, seizure medication, steroids, imaging, driving, work and rehabilitation, and who is responsible for each part.
Recognised by major UK insurers
Craniotomy is generally covered by major UK insurers when medically indicated. We confirm cover, excesses and any exclusions before booking.
Frequently asked
Everything we get asked about craniotomy.
Quick answers on awake surgery, imaging, ICU, recovery time, and when to go straight to A&E.
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What is a craniotomy?
A craniotomy is a neurosurgical operation in which a piece of skull is temporarily removed to allow the surgeon to reach the brain. Once the underlying problem is treated, the bone is replaced and fixed in position with tiny plates and screws.
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Why might I need a craniotomy?
The commonest reasons are a brain tumour (glioma, meningioma or metastasis), a haematoma pressing on the brain, an aneurysm or AVM, drug-resistant epilepsy, functional neurosurgery, or decompression for severe swelling.
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What is an awake craniotomy and why would I have one?
For tumours in or near the areas that control speech, movement or vision, the surgeon may wake you during part of the operation to map those functions in real time. It reduces the risk of a new deficit while allowing more tumour to be removed.
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How do neuronavigation, intraoperative MRI and 5-ALA help?
Neuronavigation acts as a GPS built from your pre-operative MRI. Intraoperative MRI checks how much tumour is left before closing. 5-ALA is a drink that makes glioma tissue glow pink under blue light, so the surgeon can see the edge of the tumour.
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How long is the operation and the hospital stay?
A craniotomy typically takes four to eight hours in theatre. You spend the first 24–48 hours in a neurosurgical ICU, then the ward. Most people are home within three to seven days for tumour surgery, longer for vascular cases.
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What are the main risks?
Bleeding, cerebral swelling, seizures, infection, CSF leak, DVT and pulmonary embolism, and new or worse neurological deficits. Overall risk depends heavily on the indication, the location and your baseline health — the surgeon quantifies it for your case.
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How long does recovery take?
The scalp wound heals in two weeks. Fatigue and cognitive slowing usually improve over weeks to months. Driving, work and flying restart on a timeline your surgeon sets, guided by the indication, seizure risk and how you are recovering.
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Will I need rehabilitation?
Many patients benefit from physiotherapy, occupational therapy, speech and language therapy or neuropsychology — depending on which part of the brain was operated on. We coordinate this alongside your neuro-oncology or vascular follow-up.
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How much does a private craniotomy cost in the UK?
Indicatively £28,000–£55,000 for elective tumour surgery, £35,000–£70,000 for awake craniotomy or AVM, £30,000–£60,000 for aneurysm clipping. Firm quotes are given after the consultant reviews your imaging.
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When should I go straight to A&E?
A sudden severe headache, new weakness or numbness, a seizure, sudden vision or speech change, or loss of consciousness are neurosurgical emergencies. Call 999 or go straight to A&E — do not wait for a clinic appointment.
Sources
- Society of British Neurological Surgeons. Standards and guidance for neurosurgery.
- National Institute for Health and Care Excellence. Brain tumours (primary) and brain metastases in adults (NG99).
- American Association of Neurological Surgeons. Patient information — craniotomy.
- European Association of Neurosurgical Societies. Clinical guidelines and training standards.
Related treatments
Looking for something more specific?
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Craniotomy for glioma
Awake mapping, 5-ALA fluorescence and maximal safe resection.
Learn more -
Craniotomy for glioblastoma
Resection with adjuvant chemoradiotherapy planning.
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Craniotomy for meningioma
Skull base and convexity meningioma resection.
Learn more -
Craniotomy for extradural haematoma
Emergency evacuation of a bleed above the dura.
Learn more -
Cranioplasty
Reconstruction of the skull after craniectomy.
Learn more -
All tests and procedures
Every test and procedure we arrange.
Learn more -
Migraine
Related condition guide.
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Multiple Sclerosis
Related condition guide.
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Eeg
Related diagnostic test.
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Nerve Conduction Studies
Related diagnostic test.
Learn more
In practice, in London
The London pathway for craniotomy
For craniotomy, the private London route is mostly about consultant fit and hospital choice rather than raw waiting time. The NHS route for craniotomy is thorough, but the queue is real. Most patients we speak with have been told to expect anywhere from a handful of weeks to several months, depending on their local trust and how the referral is graded. Going private in London usually collapses that window to a matter of days — often the same week if the diary allows. It isn’t about jumping a queue so much as buying time back while you still have the flexibility to plan around it.
In practice, a private craniotomy appointment in London means a named consultant, a proper hour in the room (or the equivalent on a video call), and a report you can actually read. Most of the imaging suites and endoscopy units we use sit within a mile of Harley Street or in Chelsea and Fulham, and turnaround on findings is measured in days, not weeks. For craniotomy in particular, we bias towards consultants who do this every week rather than every month.
Where a good concierge earns its keep is in the matching. There are dozens of consultants in London who see craniotomy — but not all of them are the right fit for every case. We narrow it down based on subspecialty, insurer coverage, the specific question being asked, and whether continuity into treatment matters. The right first appointment saves you from repeating yourself later.