Review of Cranioplasty after Decompressive Craniectomy

Abstract

Cranioplasty is an in evitable operation conducted after decompressive craniectomy (DC). The primary goals of cranioplasty after DC are to protect the brain, achieve a natural appearance and prevent sinking skin flap syndrome (or syndrome of the trephined). Furthermore, restoring patients' functional outcome and supplementing external defects helps patients improve their self-esteem. Although early cranioplasty is preferred in recent year, optimal timing for cranioplasty remains a controversial topic. Autologous bone flaps are the most ideal substitute for cranioplasty. Complications associated with cranioplasty are also variable, however, post-surgical infection is most common. Many new materials and techniques for cranioplasty are introduced. Cost-benefit analysis of these new materials and techniques can result in different outcomes from different healthcare systems.

Keywords: Complications; Cosmetics; Cost-Benefit analysis; Cranioplasty; Outcome.

FIGURE 1. Brain computed tomography (CT) three-dimensional (3D) reconstructions after cranioplasty with Titanium skull flap. Bone flap is made by 3D printing with electron beam melting technique. Pre-craniectomy brain CT and pre-cranioplasty CT were used for tailored flap. Subgaleal drain catheter is seen above metal flap. (A) Frontal view, (B) Right lateral view, and (C) Apical view.