VR Lab

Intracranial Hematoma Craniotomy

Drilling in the skull

Head trauma commonly occurs on the battlefield. Resulting brain injuries and bleeding within the skull (intracranial hematoma) can elevate intracranial pressure, leading to complications and death if not treated. A craniotomy may be required for treatment when conservative measures are ineffective. This procedure involves cutting a skin flap from the scalp, and removing a section of the skull to stop bleeding and relieve intracranial pressure. Learning to perform this procedure safely requires considerable practice. A surgical simulator can augment current training methods so trainees become proficient before working on patients.

Retracting the skin

We are developing a Virtual Reality-based training simulator to practice the skills required to perform a craniotomy. Several key steps from a craniotomy have been addressed, including scalp cutting and retraction, and simulation of various bone cutting tools that are typically used in clinical practice. Realistic 3D models of surgical tools have been created from real instruments, and are controlled by a haptic device during their use. When completed, the simulator will enable trainees to perform the entire craniotomy procedure on a virtual patient.


This video demonstrates the steps of the ICH simulator. The user starts with a scalpel to make the question mark incision. Then the scalp is peeled away from the skull. The final steps involve drilling four holes in the bone and cutting the bone between the holes essentially connecting the dots.

Project Members (Past and Present)

Eric Acosta, Valerie Henry, Jennifer Sieck, and Alan Liu


We would like to thank Penny Christian from Medtronic and Jason Martin from Stryker for the loan of surgical tools used as a basis for creating their virtual counterparts.

This work is supported by the U.S. Army Medical Research and Materiel Command under Contract No. W81WH-05-C-0142. The views, opinions and/or findings contained in this report are those of the author(s) and should not be construed as an official Department of the Army position, policy or decision unless so designated by other documentation.