A burr hole is made through the normal skull near the fractured portion, and Adson's elevator is introduced.
However, care should be taken not to excise too much dura as it may increase the chances for spread of infection into the subarachnoid space.
In case of dural loss, the defect is closed using a transplant from fascia lata or pericranium given that there is not much contamination of the dura.
All devitalized brain tissues are removed along with extravasated blood, foreign bodies and pieces of bone.
Following dural repair, skull deficit is treated by using moulded tantalum plates or acrylic inlays, three to six months after the head injury.