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Type: Journal article
Title: A case series of early and late cranioplasty—comparison of surgical outcomes
Author: Bjornson, A.
Tajsic, T.
Kolias, A.G.
Wells, A.
Naushahi, M.J.
Anwar, F.
Helmy, A.
Timofeev, I.
Hutchinson, P.J.
Citation: Acta Neurochirurgica: the European journal of neurosurgery, 2019; 161(3):467-472
Publisher: Springer
Issue Date: 2019
ISSN: 0001-6268
Statement of
Anna Bjornson, Tamara Tajsic, Angelos G. Kolias, Adam Wells, Mohammad J. Naushahi, Fahim Anwar ... et al.
Abstract: BACKGROUND:Cranioplasty is an increasingly common procedure performed in neurosurgical centres following a decompressive craniectomy (DC), however, timing of the procedure varies greatly. OBJECTIVES:The aim of this study is to compare the surgical outcomes of an early compared to a late cranioplasty procedure. METHODS:Ninety adult patients who underwent a prosthetic cranioplasty between 2014 and 2017 were studied retrospectively. Timing of operation, perioperative complications and length of stay were assessed. Early and late cranioplasties were defined as less or more than 3 months since craniectomy respectively. RESULTS:Of the 90 patients, 73% received a late cranioplasty and 27% received an early cranioplasty. The median interval between craniectomy and cranioplasty was 13 months [range 3-84] in late group versus 54 days [range 33-90] in early group. Twenty-two patients in the early group (91%) received a cranioplasty during the original admission while undergoing rehabilitation. Complications were seen in 25 patients (28%). These included wound or cranioplasty infection, hydrocephalus, symptomatic pneumocephalus, post-operative haematoma and cosmetic issues. The complication rate was 21% in the early group and 30% in the late group (P value 0.46). There was no significant difference in the rate of infection or hydrocephalus between the two groups. Length of stay was not significantly increased in patients who received an early cranioplasty during their initial admission (median length of stay 77 days versus 63 days, P value 0.28). CONCLUSION:We have demonstrated the potential for early cranioplasty to be a safe and viable option, when compared to delayed cranioplasty.
Keywords: Neurosurgery; complications; cranial reconstruction; craniectomy
Rights: © The Author(s) 2019. This article is distributed under the terms of the Creative Commons At tribution 4.0 International License (http:/ /, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
DOI: 10.1007/s00701-019-03820-9
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