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Schematic illustration of posterior cranial vault distraction with barrel stave osteotomy. A biparietal is performed and a transverse occipital osteotomy is made about 2 cm below Inion. Barrel stave osteotomy is also performed to expand subtentrial region. In the case with chronic tonsillar herniation, foramen magnum decompression is made. Finally, distractors are applied. (From CP Neurosurg 23: 1025–1031–2013,5) with permission.)
