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Başkent University Faculty of Medicine, Department of Neurosurgery, Ankara, Turkey This technical note describes a surgical technique than can be used to reconstruct the craniotomy flap in cases of severe brain swelling. Extensive craniotomy with duraplasty and drilling of the inner table of the craniotomy bone flap are the main features of the method. In appropriate cases, this technique is a good, cost-effective physiologic alternative to synthetic cranioplasty materials. Keywords : Brain edema, cranioplasty, surgical treatment