Abstract: Disclosed is a craniotomy milling system, which includes a computer numerical milling machine having a spindle configured to be positioned relative to a craniotomy location of a cranium of a patient and an end mill. The craniotomy milling system includes a controller for controlling the feed rate of the end mill. The craniotomy milling system includes an impedance measurement system and an axial force sensor. The craniotomy milling system includes a processor electrically coupled with a controller, the impedance measurement system, and the axial force sensor. The processor is configured to send a signal to the controller to change the feed rate of the end mill in response to a change in impedance or a change in axial force.

Abstract: The disclosure provides an apparatus and methods for performing a piotomy on a mammal comprising: performing a craniotomy to remove the skull and expose dura mater; removing the dura mater and arachnoid mater to expose subarachnoid space; and performing a piotomy using a laser to create a hole and expose the cerebral cortex.

Abstract: The disclosure provides an apparatus and methods for performing a piotomy on a mammal comprising: performing a craniotomy to remove the skull and expose dura mater; removing the dura mater and arachnoid mater to expose subarachnoid space; and performing a piotomy using a laser to create a hole and expose the cerebral cortex.