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. 2021 Feb;163(2):423-440.
doi: 10.1007/s00701-020-04663-5. Epub 2020 Dec 22.

Consensus statement from the international consensus meeting on post-traumatic cranioplasty

C Iaccarino  1 , A Kolias  2   3 , P D Adelson  4 , A M Rubiano  5 , E Viaroli  6 , A Buki  7 , G Cinalli  8 , K Fountas  9 , T Khan  10 , S Signoretti  11 , V Waran  12 , A O Adeleye  13 , R Amorim  14 , A Bertuccio  15 , A Cama  16 , R M Chesnut  17   18 , P De Bonis  19 , A Estraneo  20   21 , A Figaji  22 , S I Florian  23 , R Formisano  24 , P Frassanito  25 , C Gatos  26 , A Germanò  27 , C Giussani  28 , I Hossain  29 , P Kasprzak  30 , F La Porta  31 , D Lindner  32 , A I R Maas  33 , W Paiva  34 , P Palma  35 , K B Park  36 , P Peretta  37 , A Pompucci  38 , J Posti  39 , S K Sengupta  40 , A Sinha  41 , V Sinha  42 , R Stefini  43 , G Talamonti  44 , A Tasiou  26 , G Zona  45   46 , M Zucchelli  47 , P J Hutchinson  6 , F Servadei  48   49
Affiliations

Consensus statement from the international consensus meeting on post-traumatic cranioplasty

C Iaccarino et al. Acta Neurochir (Wien). 2021 Feb.

Abstract

Background: Due to the lack of high-quality evidence which has hindered the development of evidence-based guidelines, there is a need to provide general guidance on cranioplasty (CP) following traumatic brain injury (TBI), as well as identify areas of ongoing uncertainty via a consensus-based approach.

Methods: The international consensus meeting on post-traumatic CP was held during the International Conference on Recent Advances in Neurotraumatology (ICRAN), in Naples, Italy, in June 2018. This meeting was endorsed by the Neurotrauma Committee of the World Federation of Neurosurgical Societies (WFNS), the NIHR Global Health Research Group on Neurotrauma, and several other neurotrauma organizations. Discussions and voting were organized around 5 pre-specified themes: (1) indications and technique, (2) materials, (3) timing, (4) hydrocephalus, and (5) paediatric CP.

Results: The participants discussed published evidence on each topic and proposed consensus statements, which were subject to ratification using anonymous real-time voting. Statements required an agreement threshold of more than 70% for inclusion in the final recommendations.

Conclusions: This document is the first set of practical consensus-based clinical recommendations on post-traumatic CP, focusing on timing, materials, complications, and surgical procedures. Future research directions are also presented.

Keywords: Cranioplasty; Decompressive craniectomy; Neurosurgery; Rehabilitation; hydrocephalus.

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Conflict of interest statement

Corrado Iaccarino received consultancy fees from Finceramica, producing HA cranioplasty. Franco Servadei received unconditional grants and consultancy fees from Finceramica and Intergra, both producing HA cranioplasty and from Johnson and Johnson, producing PEEK Cranioplasty. Paolo Frassanito received consultancy fees from Finceramica and Integra, producing HA cranioplasty. Edoardo Viaroli received consultancy fees from Finceramica, producing HA cranioplasty.

All other authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

References

    1. Aarabi B, Chesler D, Maulucci C, Blacklock T, Alexander M. Dynamics of subdural hygroma following decompressive craniectomy: a comparative study. Neurosurg Focus. 2009;26(6):E8. doi: 10.3171/2009.3.FOCUS0947. - DOI - PubMed
    1. Adeleye AO, Azeez AL. Decompressive craniectomy bone flap hinged on the temporalis muscle: a new inexpensive use for an old neurosurgical technique. Surg Neurol Int. 2011;2:150. doi: 10.4103/2152-7806.86227. - DOI - PMC - PubMed
    1. Baskaran V, Štrkalj G, Štrkalj M, Di Ieva A. Current applications and future perspectives of the use of 3D printing in anatomical training and neurosurgery. Front Neuroanat. 2016;10:69. doi: 10.3389/fnana.2016.00069. - DOI - PMC - PubMed
    1. Beauchamp KM, Kashuk J, Moore EE, Bolles G, Rabb C, Seinfeld J, Szentirmai O, Sauaia A. Cranioplasty after postinjury decompressive craniectomy: is timing of the essence? J Trauma. 2010;69(2):270–274. doi: 10.1097/TA.0b013e3181e491c2. - DOI - PubMed
    1. Beez T, Munoz-Bendix C, Ahmadi SA, Steiger HJ, Beseoglu K. From decompressive craniectomy to cranioplasty and beyond – a pediatric neurosurgery perspective. Childs Nerv Syst. 2019;35(9):1517–1524. doi: 10.1007/s00381019-04303-z. - DOI - PubMed

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