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Supratentorial craniotomy is a common case in neurosurgery during which both the neurosurgeon and anesthesiologist are modulating the same organ. This chapter presents a case study of a 61-year-old female who presented with new-onset seizures, which were preceded by several weeks of bilateral frontal headaches described as dull and achy. The patient was scheduled for tumor excision via stealth-guided craniotomy. The patient's anxiety, increased blood pressure, and bronchospasm were addressed immediately. The patient emerged within several minutes of the head dressing being applied, without bucking or coughing. Normally, a patient presenting for supratentorial craniotomy is best served by an organized and systematic approach. The chapter presents one strategy for the preoperative evaluation of these neurosurgical patients. Supratentorial craniotomy is a common case in neurosurgery during which both the neurosurgeon and anesthesiologist are modulating the same organ. Thoughtful planning and clear communication between the teams is required for optimal patient care.