Wrong-Site Craniotomy Prevention

  • Daniel Mendelsohn
  • Mark Bernstein
Part of the Tumors of the Central Nervous System book series (TCNS, volume 9)


Wrong-site surgery (WSS) is a devastating error that has gained increasing attention in the medical community and the general public. Wrong-site craniotomy (WSC) in particular, is an uncommon event but carries the potential of serious neurologic harm. Here we describe the clinical and legal outcomes of known WSC cases, the factors contributing to the errors, systems for prevention, the evidence for preventative systems, and future directions. Ultimately, the elimination of this lamentable error will require improving communication in the OR, embracing systematic verification procedures, incorporating novel verification technologies, and the open reporting of cases to facilitate thorough error analyses and the development of effective preventative strategies.


Trigeminal Neuralgia Joint Commission Mandatory Reporting Verification Procedure Universal Protocol 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer Science+Business Media Dordrecht 2012

Authors and Affiliations

  1. 1.Division of NeurosurgeryToronto Western HospitalTorontoCanada

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