OBJECTIVE Prolonged improvement in neurological and mental disorders has been seen after only cranioplasty in patients initially treated with external decompression for high intracranial pressure. The objective was to evaluate, using 133Xe CT and 31P magnetic resonance spectroscopy (MRS), how restoring the bone itself can influence cerebral blood flow and cerebral energy metabolism after high i...

Temporalis muscle reconstruction is a necessary step during frontotemporal cranioplasty ensuing decompressive craniectomy (DC). During this procedure, scarring between the temporalis muscle and the dural layer may lead to complicated muscle dissection, which carries an increased risk of dura and muscle damage. At time of DC, temporalis muscle wrapping by an autologous vascularized dural flap ca...

The syndrome of the sinking skin flap (SSSF) has been described as one of the causes of neurological deficits after decompressive craniectomy We report a case of a 57-year-old woman with SSSF. Two years earlier, this patient, with no neurological deficits, underwent removal of the bone flap during treatment of an epidural abscess due to wound infection after a clipping operation for a ruptured ...

OBJECT Decompressive craniectomy plays an important role in the management of patients with traumatic brain injury (TBI) and stroke. Risks of decompressive craniectomy include those associated with cranioplasty, and may be related to adhesions that develop between the brain surface and overlying scalp and temporalis muscle. The authors report their institutional experience using a multilayered ...

Abstract Cranioplasty is a procedure in which the bone flap replaced after decompressive craniotomy, once patient’s condition stabilizes. Rapid recovery important this surgery for recognizing early complications and immediate intervention. Newer inhalation agents such as desflurane sevoflurane are widely used neurosurgery. But not much research has been done anesthetic management elective crani...

BACKGROUND With decompressive craniectomy for ischemic stroke, traumatic brain injury, and skull-infiltrating tumors, the need for cranioplasty has increased. Different materials for custom-made cranioplasties have been evaluated, but a gold standard could not yet be established. We report our experience with the new custom-made titanium CRANIOTOP(®)cranioplasty (CL Instruments, Germany). MET...

Herein, we report an unusual case of a patient who presented with a severe, sinking skin flap after a decompressive craniectomy and ventriculoperitoneal shunt surgery due to a traumatic brain injury. After cranioplasty, the patient's neurological deficiency improved and was confirmed by transcranial Doppler sonography. In addition to discussing the pathogenesis of the sinking skin flap, we emph...

Abstract Titanium cranioplasty is one of the well-established and widely used techniques in restoring skull defects for optimal protection to skull internal structures and reestablishing skull conformity. Nowadays, most centres utilise computer-assisted reconstruction for manufacture of titanium plates. In this paper we presented a method for making titanium cranioplasty plates using the 3D inn...

BACKGROUND The list of complications reported after decompressive craniectomy (DC) and cranioplasty is progressively increasing. Nonetheless, the exact incidence of these events is still ill-defined. Problems affecting skin flaps after DC and cranioplasty have never been accurately analyzed in papers and their impact on patients' prognosis is largely underestimated. METHODS In a 10-year time,...

The “functional” morbidity in nonsyndromic craniosynostosis is not obvious. Because of this disconnect between cranial deformity and “functional” disability, cranial reconstructive surgery in patients with single-suture sagittal craniosynostosis has been regarded as a “cosmetic” intervention. However, it has been observed in a preliminary study that children with simple craniosynostosis often h...