. 2025 Feb 17:5:104214.

doi: 10.1016/j.bas.2025.104214. eCollection 2025.

The current state of cranioplasty in Europe - Results from a European cranioplasty survey

Paul Vincent Naser^{1

2

3

4}, Parmenion Tsitsopoulos⁵, Friederike Zacharias^{1

2}, Ana M Castaño-Leon⁶, Andras Buki⁷, Bart Depreitere⁸, Thomas Van Essen⁹, Tommi K Korhonen¹⁰, Harry Mee¹¹, Iftakher Hossain¹², Jussi Posti¹², Laura Lippa¹³, Marios C Papadopoulos¹⁴, Nicole Terpolilli¹⁵, Niklas Marklund^{16

17}, Ondra Petr¹⁸, Peter Toth¹⁹, Teemu Luoto²⁰, Sandro M Krieg^{1

2}, Andreas W Unterberg^{1

2}, Alexander Younsi^{1

2}; European Cranioplasty Survey Group

Collaborators, Affiliations

Collaborators

European Cranioplasty Survey Group:
Samiya Abi Jaoude²¹, Mejdeddine Al Barajraji²², Alexios Bimpis²³, Andreas Zigouris²⁴, Artur Xhumari²⁵, Sefa Ozturk²⁶, Eduarda Sá-Marta²⁷, Elias Antoniades²⁸, Efkleidis Chronakis²⁹, Francesco Travaglini³⁰, Charalampos Gatos³¹, George A Alexiou³², Theodore Gerasimou³³, Markus Holling³⁴, Ibrahim E Efe³⁵, Ioannis Mavridis³⁶, Savvas Grigoriadis³⁷, Jacek Szczygielski^{38

39}, James Jm Loan⁴⁰, Juan Casado Pellejero⁴¹, Kęstutis Jacikevičius⁴², Konstantinos Vlachos⁴³, Konstantinos Faropoulos⁴⁴, Michał Sabramowicz⁴⁵, Magnus Olivecrona⁴⁶, Maria L Gandía-González⁴⁷, Michaël Bruneau⁴⁸, Michael Müther⁴⁹, Nikolaos Syrmos⁵⁰, Minna Oinas⁵¹, Nikolaos Paidakakos⁵², Nikolaos Foroglou⁵³, Laszlo Novak⁵⁴, Patrick Czorlich⁵⁵, Panagiotis Papadopoulos-Manolarakis⁵⁶, Dimitrios Papafragkos⁵⁷, Torstein R Meling⁵⁸, Richard Drexler⁵⁵, Jose L Sanmillan⁵⁹, Senne Broekx⁶⁰, Nikolaos Skoulios²⁷, Sotirios Karatzoglou⁶¹, Piotr Stogowski⁶², Theodosios Stamatopoulos⁶³, Thomas Petutschnigg⁶⁴, Vassilios Tsitouras²⁷, Christos Tsitsipanis⁶⁵

Affiliations

¹ Heidelberg University Hospital, Department of Neurosurgery, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
² Heidelberg University, Medical Faculty, Grabengasse 1, 69117, Heidelberg, Germany.
³ Heidelberg University Hospital, Division of Stereotactic Neurosurgery, Department of Neurosurgery, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
⁴ AI Health Innovation Cluster, German Cancer Research Center (DKFZ), Heidelberg, Germany.
⁵ Department of Neurosurgery, Hippokration General Hospital, Aristotle University School of Medicine, Konstantinoupoleos 49, 54642, Thessaloniki, Greece.
⁶ Neurosurgery Department, Av. Cordoba S/n, 28041, Madrid, Spain.
⁷ Department of Neurosurgery Örebro University Hospital, Södra Grev Rosengatan 42, 70362, Örebro, Sweden.
⁸ Neurosurgery, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.
⁹ Neurosurgery, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, Netherlands.
¹⁰ Neurosurgery, OYS Neurocenter, Oulu University Hospital, Kajaanintie 50, 90029, Oulu, Finland.
¹¹ Clinical Neurosciences, Addenbrookes Hospital, CB2 0QQ, Cambridge, United Kingdom.
¹² Neurocenter, Department of Neurosurgery, Turku University Hospital, Hämeentie 11, 20521, Turku, Finland.
¹³ UOC Neurosurgery, ASST Ospedale Niguarda, Milano, Piazza Dell'ospedale Maggiore 1, 20162, Milan, Italy.
¹⁴ Neurosurgery, Atkinson Morley Wing, St. George's Hospital, Blackshaw Road, SW17 0QT, London, United Kingdom.
¹⁵ Ludwig-Maximilians-Universität Munich, Department of Neurosurgery, Marchioninistr. 15, 81377, Munich, Germany.
¹⁶ Department of Clinical Sciences Lund, Neurosurgery, Klinikgatan 17A, EA-blocket, 4th Floor, 22185, Lund, Sweden.
¹⁷ Department of Clinical Sciences Lund, Neurosurgery, Lund University, Skåne University, Hospital, Lund, Sweden.
¹⁸ Department of Neurosurgery, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
¹⁹ Department of Neurosurgery, University of Pecs, Hubgary, Ret street 2, Pecs, Hungary.
²⁰ Department of Neurosurgery, Tampere University Hospital, PL 2000, 33521, Tampere, Poland.
²¹ Hopital Fondation Adolphe De Rothschild - Neurochirurgie Adulte, 29 Rue Manin, 75019, Paris, France.
²² Department of Neurosurgery, CHUV, Lausanne, Switzerland.
²³ Neurosurgical Clinic General Hospital of Tripoli Arcadia Greece, Terma Erythrou Staurou, 22131 Tripoli, Greece.
²⁴ Department of Neurosurgery, University Hospital of Ioannina, Ioannina, Greece.
²⁵ Service of Neurosurgery, UHC "Nene Tereza", Rr. Kongresi I Manastirit 372, 1008, Tirana, Albania.
²⁶ Department of Neurosurgery, Istanbul University Istanbul Faculty of Medicine, 34093, Istanbul, Turkey.
²⁷ Department of Neurosurgery, Braga Hospital (ULS Braga), Sete Fontes - São Victor, 4710-243, Braga, Portugal.
²⁸ Neurosurgery - General Hospital Ippokrateio,Konstantinoupoleos 49, 54642, Thessaloniki, Greece.
²⁹ Neurosurgical Clinic of General Hospital of Irakleio, Crete, Knossou Str, 71409, IRAKLEIO, Greece.
³⁰ Department of Neurosurgery, Arcispedale Sant'Anna, Via Aldo Moro 8, 44124, Ferrara, Italy.
³¹ University Hospital of Larissa Greece, Mezurlo Larisa, 41334, LARISA, Greece.
³² Neurosurgery, University of Ioannina, St. Niarhou 45500, Ioannina, Greece.
³³ Neurosurgical Department, General State Hospital of Peiraeus "Tzaneio", Zanni & Afentouli Str., 1, 18534, Athens, Greece.
³⁴ Department of Neurosurgery, University Hospital Münster, Albert-Schweitzer-Campus 1A, 48149, Münster, Germany.
³⁵ Department of Neurosurgery, Charitéplatz 1, 10117, Berlin, Germany.
³⁶ Department of Neurosurgery, University General Hospital of Alexandroupolis, 6th Klm Alexandroupolis-Makris Rd, 68100, Alexandroupolis, Greece.
³⁷ B' Neurosurgical Clinic, Aristotle University of Thessaloniki, Iktinou 16, Thessaloniki, 546 22, Greece.
³⁸ Department of Neurosurgery, Institute of Medical Sciences, University of Rzeszów, ul. Warzywna, 1a, 35-310, Rzeszów, Poland.
³⁹ Department of Neurosurgery, Saarland University Hospital and Saarland University Medical Center, Kirrberger Str. Geb. 90.5, 66421, Homburg, Saar, Germany.
⁴⁰ Department of Neurosurgery, Aberdeen Royal Infirmary, Foresterhill Road, AB25 2ZN, Aberdeen, United Kingdom.
⁴¹ Neurosurgery Department. University Hospital Miguel Servet. Calle Isabel la Catolica, Zaragoza, Spain.
⁴² Dept. of Neurosurgery, Liepojos St. 41, 92288, Klaipeda, Lithuania.
⁴³ Department of Neurosurgery, "KAT" Hospital, 2 Nikis str, 14561, Kifisia, Greece.
⁴⁴ Nicosia General Hospital, Old Nicosia Limassol Rd 215, 2029, Nicosia, Cyprus.
⁴⁵ Neurosurgery, Św. Józefa 53-59, 87-100, Toruń, Poland.
⁴⁶ Dep of Neurosurgery Univerity Hospital Örebro, Grev Rosengatan, 70185, Örebro, Sweden.
⁴⁷ Hospital Universitario La Paz, Paseo Castellana 261, 28046, Madrid, Spain.
⁴⁸ Neurosurgery UZ Brussel VUB Vrije Universiteit Brussel, Laerbeeklaan 101, 1090, Brussels, Belgium.
⁴⁹ Department of Neurosurgery, University Hospital Münster, Münster, Albert-Schweitzer-Campus 1A, 48149, Münster, Germany.
⁵⁰ Aristotle University of Thessaloniki, Karamaouna 16, Κalamaria, PC 55132, Thessaloniki, Greece.
⁵¹ Department of Neurosurgery, Kuopio University Hospital, P.O. BOX 100, 70029, KYS, Finland.
⁵² Department of Neurosurgery, Athens General Hospital 'G. Gennimatas', Athens, Greece.
⁵³ Aristotle University Medical School, Department of Neurosurgery, AHEPA University Hospital, Thessaloniki, Greece.
⁵⁴ University of Debrecen, Clinical Centre, Department of Neurosurgery, Nagyerdei Krt., 4032, Debrece, Hungary.
⁵⁵ University Medical Center Hamburg-Eppendorf, Department of Neurosurgery, Martinistr. 52, 20246, Hamburg, Germany.
⁵⁶ Neurosurgical Department, General Hospital of Nikaia - Piraeus, Athens, 3, Dimitriou Mantouvalou, 18454, Athens, Nikaia, Greece.
⁵⁷ Neurosurgery, L. Gennimata 1, 19018, Magoula, Greece.
⁵⁸ Dept. of Neurosurgery, Rigshospitalet, Copenhagen University Hospital, Inge Lehmanns Vej 6, 2100, Copenhagen, Denmark.
⁵⁹ Neurosurgery Deparment, Hospital Universitari De Bellvitge, C Feixa Llarga, 8907, Hospitalet De Llobregat, Spain.
⁶⁰ Neurosurgery, Drie Eikenstraat 655, 2650, Edegem, Belgium.
⁶¹ Interbalkan Medical Centre, Asklipiou 17, 57001, Thessaloniki, Greece.
⁶² Department of Neurosurgery, Copernicus Hospital in Gdansk, Nowe Ogrody 1-6, 80-288, Gdansk, Poland.
⁶³ Neurosurgery Department, Whitechapel Rd, London E1 1FR, UK, E1 1BB, London, United Kingdom.
⁶⁴ Department of Neurosurgery, Inselspital Bern University Hospital and University of Bern, Rosenbühlgasse 25, 3010, Bern, Switzerland.
⁶⁵ Neurosurgery Department, Leof. Panepistimiou, 71500, Heraklion, Greece.

PMID: 40103849
PMCID: PMC11914825
DOI: 10.1016/j.bas.2025.104214

The current state of cranioplasty in Europe - Results from a European cranioplasty survey

Paul Vincent Naser et al. Brain Spine. 2025.

. 2025 Feb 17:5:104214.

doi: 10.1016/j.bas.2025.104214. eCollection 2025.

Authors

Collaborators

European Cranioplasty Survey Group:
Samiya Abi Jaoude²¹, Mejdeddine Al Barajraji²², Alexios Bimpis²³, Andreas Zigouris²⁴, Artur Xhumari²⁵, Sefa Ozturk²⁶, Eduarda Sá-Marta²⁷, Elias Antoniades²⁸, Efkleidis Chronakis²⁹, Francesco Travaglini³⁰, Charalampos Gatos³¹, George A Alexiou³², Theodore Gerasimou³³, Markus Holling³⁴, Ibrahim E Efe³⁵, Ioannis Mavridis³⁶, Savvas Grigoriadis³⁷, Jacek Szczygielski^{38

39}, James Jm Loan⁴⁰, Juan Casado Pellejero⁴¹, Kęstutis Jacikevičius⁴², Konstantinos Vlachos⁴³, Konstantinos Faropoulos⁴⁴, Michał Sabramowicz⁴⁵, Magnus Olivecrona⁴⁶, Maria L Gandía-González⁴⁷, Michaël Bruneau⁴⁸, Michael Müther⁴⁹, Nikolaos Syrmos⁵⁰, Minna Oinas⁵¹, Nikolaos Paidakakos⁵², Nikolaos Foroglou⁵³, Laszlo Novak⁵⁴, Patrick Czorlich⁵⁵, Panagiotis Papadopoulos-Manolarakis⁵⁶, Dimitrios Papafragkos⁵⁷, Torstein R Meling⁵⁸, Richard Drexler⁵⁵, Jose L Sanmillan⁵⁹, Senne Broekx⁶⁰, Nikolaos Skoulios²⁷, Sotirios Karatzoglou⁶¹, Piotr Stogowski⁶², Theodosios Stamatopoulos⁶³, Thomas Petutschnigg⁶⁴, Vassilios Tsitouras²⁷, Christos Tsitsipanis⁶⁵

Affiliations

¹ Heidelberg University Hospital, Department of Neurosurgery, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
² Heidelberg University, Medical Faculty, Grabengasse 1, 69117, Heidelberg, Germany.
³ Heidelberg University Hospital, Division of Stereotactic Neurosurgery, Department of Neurosurgery, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
⁴ AI Health Innovation Cluster, German Cancer Research Center (DKFZ), Heidelberg, Germany.
⁵ Department of Neurosurgery, Hippokration General Hospital, Aristotle University School of Medicine, Konstantinoupoleos 49, 54642, Thessaloniki, Greece.
⁶ Neurosurgery Department, Av. Cordoba S/n, 28041, Madrid, Spain.
⁷ Department of Neurosurgery Örebro University Hospital, Södra Grev Rosengatan 42, 70362, Örebro, Sweden.
⁸ Neurosurgery, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.
⁹ Neurosurgery, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, Netherlands.
¹⁰ Neurosurgery, OYS Neurocenter, Oulu University Hospital, Kajaanintie 50, 90029, Oulu, Finland.
¹¹ Clinical Neurosciences, Addenbrookes Hospital, CB2 0QQ, Cambridge, United Kingdom.
¹² Neurocenter, Department of Neurosurgery, Turku University Hospital, Hämeentie 11, 20521, Turku, Finland.
¹³ UOC Neurosurgery, ASST Ospedale Niguarda, Milano, Piazza Dell'ospedale Maggiore 1, 20162, Milan, Italy.
¹⁴ Neurosurgery, Atkinson Morley Wing, St. George's Hospital, Blackshaw Road, SW17 0QT, London, United Kingdom.
¹⁵ Ludwig-Maximilians-Universität Munich, Department of Neurosurgery, Marchioninistr. 15, 81377, Munich, Germany.
¹⁶ Department of Clinical Sciences Lund, Neurosurgery, Klinikgatan 17A, EA-blocket, 4th Floor, 22185, Lund, Sweden.
¹⁷ Department of Clinical Sciences Lund, Neurosurgery, Lund University, Skåne University, Hospital, Lund, Sweden.
¹⁸ Department of Neurosurgery, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
¹⁹ Department of Neurosurgery, University of Pecs, Hubgary, Ret street 2, Pecs, Hungary.
²⁰ Department of Neurosurgery, Tampere University Hospital, PL 2000, 33521, Tampere, Poland.
²¹ Hopital Fondation Adolphe De Rothschild - Neurochirurgie Adulte, 29 Rue Manin, 75019, Paris, France.
²² Department of Neurosurgery, CHUV, Lausanne, Switzerland.
²³ Neurosurgical Clinic General Hospital of Tripoli Arcadia Greece, Terma Erythrou Staurou, 22131 Tripoli, Greece.
²⁴ Department of Neurosurgery, University Hospital of Ioannina, Ioannina, Greece.
²⁵ Service of Neurosurgery, UHC "Nene Tereza", Rr. Kongresi I Manastirit 372, 1008, Tirana, Albania.
²⁶ Department of Neurosurgery, Istanbul University Istanbul Faculty of Medicine, 34093, Istanbul, Turkey.
²⁷ Department of Neurosurgery, Braga Hospital (ULS Braga), Sete Fontes - São Victor, 4710-243, Braga, Portugal.
²⁸ Neurosurgery - General Hospital Ippokrateio,Konstantinoupoleos 49, 54642, Thessaloniki, Greece.
²⁹ Neurosurgical Clinic of General Hospital of Irakleio, Crete, Knossou Str, 71409, IRAKLEIO, Greece.
³⁰ Department of Neurosurgery, Arcispedale Sant'Anna, Via Aldo Moro 8, 44124, Ferrara, Italy.
³¹ University Hospital of Larissa Greece, Mezurlo Larisa, 41334, LARISA, Greece.
³² Neurosurgery, University of Ioannina, St. Niarhou 45500, Ioannina, Greece.
³³ Neurosurgical Department, General State Hospital of Peiraeus "Tzaneio", Zanni & Afentouli Str., 1, 18534, Athens, Greece.
³⁴ Department of Neurosurgery, University Hospital Münster, Albert-Schweitzer-Campus 1A, 48149, Münster, Germany.
³⁵ Department of Neurosurgery, Charitéplatz 1, 10117, Berlin, Germany.
³⁶ Department of Neurosurgery, University General Hospital of Alexandroupolis, 6th Klm Alexandroupolis-Makris Rd, 68100, Alexandroupolis, Greece.
³⁷ B' Neurosurgical Clinic, Aristotle University of Thessaloniki, Iktinou 16, Thessaloniki, 546 22, Greece.
³⁸ Department of Neurosurgery, Institute of Medical Sciences, University of Rzeszów, ul. Warzywna, 1a, 35-310, Rzeszów, Poland.
³⁹ Department of Neurosurgery, Saarland University Hospital and Saarland University Medical Center, Kirrberger Str. Geb. 90.5, 66421, Homburg, Saar, Germany.
⁴⁰ Department of Neurosurgery, Aberdeen Royal Infirmary, Foresterhill Road, AB25 2ZN, Aberdeen, United Kingdom.
⁴¹ Neurosurgery Department. University Hospital Miguel Servet. Calle Isabel la Catolica, Zaragoza, Spain.
⁴² Dept. of Neurosurgery, Liepojos St. 41, 92288, Klaipeda, Lithuania.
⁴³ Department of Neurosurgery, "KAT" Hospital, 2 Nikis str, 14561, Kifisia, Greece.
⁴⁴ Nicosia General Hospital, Old Nicosia Limassol Rd 215, 2029, Nicosia, Cyprus.
⁴⁵ Neurosurgery, Św. Józefa 53-59, 87-100, Toruń, Poland.
⁴⁶ Dep of Neurosurgery Univerity Hospital Örebro, Grev Rosengatan, 70185, Örebro, Sweden.
⁴⁷ Hospital Universitario La Paz, Paseo Castellana 261, 28046, Madrid, Spain.
⁴⁸ Neurosurgery UZ Brussel VUB Vrije Universiteit Brussel, Laerbeeklaan 101, 1090, Brussels, Belgium.
⁴⁹ Department of Neurosurgery, University Hospital Münster, Münster, Albert-Schweitzer-Campus 1A, 48149, Münster, Germany.
⁵⁰ Aristotle University of Thessaloniki, Karamaouna 16, Κalamaria, PC 55132, Thessaloniki, Greece.
⁵¹ Department of Neurosurgery, Kuopio University Hospital, P.O. BOX 100, 70029, KYS, Finland.
⁵² Department of Neurosurgery, Athens General Hospital 'G. Gennimatas', Athens, Greece.
⁵³ Aristotle University Medical School, Department of Neurosurgery, AHEPA University Hospital, Thessaloniki, Greece.
⁵⁴ University of Debrecen, Clinical Centre, Department of Neurosurgery, Nagyerdei Krt., 4032, Debrece, Hungary.
⁵⁵ University Medical Center Hamburg-Eppendorf, Department of Neurosurgery, Martinistr. 52, 20246, Hamburg, Germany.
⁵⁶ Neurosurgical Department, General Hospital of Nikaia - Piraeus, Athens, 3, Dimitriou Mantouvalou, 18454, Athens, Nikaia, Greece.
⁵⁷ Neurosurgery, L. Gennimata 1, 19018, Magoula, Greece.
⁵⁸ Dept. of Neurosurgery, Rigshospitalet, Copenhagen University Hospital, Inge Lehmanns Vej 6, 2100, Copenhagen, Denmark.
⁵⁹ Neurosurgery Deparment, Hospital Universitari De Bellvitge, C Feixa Llarga, 8907, Hospitalet De Llobregat, Spain.
⁶⁰ Neurosurgery, Drie Eikenstraat 655, 2650, Edegem, Belgium.
⁶¹ Interbalkan Medical Centre, Asklipiou 17, 57001, Thessaloniki, Greece.
⁶² Department of Neurosurgery, Copernicus Hospital in Gdansk, Nowe Ogrody 1-6, 80-288, Gdansk, Poland.
⁶³ Neurosurgery Department, Whitechapel Rd, London E1 1FR, UK, E1 1BB, London, United Kingdom.
⁶⁴ Department of Neurosurgery, Inselspital Bern University Hospital and University of Bern, Rosenbühlgasse 25, 3010, Bern, Switzerland.
⁶⁵ Neurosurgery Department, Leof. Panepistimiou, 71500, Heraklion, Greece.

PMID: 40103849
PMCID: PMC11914825
DOI: 10.1016/j.bas.2025.104214

Abstract

Introduction: Cranioplasty, a surgical procedure to restore skull integrity and aesthetic contour following decompressive craniectomy, poses challenges in material selection and timing, driven by the lack of guidelines and ongoing regulatory changes.

Research question: This study aimed to provide an overview of current cranioplasty practices in Europe, explicitly addressing a potential shift towards alloplastic materials and the management of patients with concomitant hydrocephalus.

Material and methods: An online survey was conducted among European neurosurgical centers from January to March 2024, collecting data on material preferences, timing of procedures, and management strategies for cranioplasty. Descriptive and statistical analyses were performed on 110 complete responses.

Results: Respondents favored alloplastic materials over autologous bone for cranioplasty, citing regulatory constraints and reduced infection risk as primary reasons. Variability was observed in the timing of procedures and the management of patients with hydrocephalus, with most centers adopting staged approaches.

Discussion and conclusion: The shift towards alloplastic materials in cranioplasty reflects regulatory pressures rather than material-specific considerations. Despite variability in practice, our findings underscore the need for standardized guidelines and further research to optimize patient outcomes. This study provides valuable insights into current practices and highlights areas for future investigation in cranioplasty.

Keywords: Alloplastic materials; Autologous bone; Cranioplasty; European survey; Hydrocephalus management; Regulatory changes.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

**Fig. 1**
Study participants. A: Demographic information of survey participants (top left). Caseloads of decompressive craniectomy (top right), naïve (bottom left), and revision cranioplasty (bottom right) differed between centers. B: Colored map illustrating the location of practice of participating neurosurgeons; numerical data on the number of participants for each country are provided in Table 1.

**Fig. 2**
Preferences in material selection for cranioplasty. A:*Pie-chart illustrating the distributions of surgeons preferring alloplastic (red) materials or autologous bone (grey) for cranioplasty.*B:*Pie-chart illustrating the distributions of alloplastic materials used as first-line material in cranioplasty.*C:*Material preferences were not significantly different between high and low-volume centers (for definition, see text (*Fisher's exact test, p = 0.5). D:The reasons for choosing autologous and alloplastic materials were differed between alloplastic materials and autologous CP. Bar graphs denoting the number of responses. Note that participants could provide multiple reasons for each material.E:*No significant difference was detected between the preferred time-point for cranioplasty when comparing surgeons preferring alloplastic and autologous bone (Fisher's exact test, p=0.3).*

**Fig. 3**
Practices of bone-fragment storage, pediatric cranioplasty, and management of hydrocephalus **A: Management of bone fragment storage.**Pie-chart illustrating the practices of bone fragment storage (left). More than half of centers seek informed consent from patients (resp. next of kin) when storing bone fragments (middle, top), but more than 60% do not notify next of kin when bone fragments are discarded (middle, bottom). Maximal storage time was limited by institutional guidelines in most centers (right).B: Management of cranioplasty in children.Survey participants favored an earlier cranioplasty compared to adults (X2, p=0.0007). In pediatric patients, most respondents favored autologous bone cranioplasty (right, top). When alloplastic cranioplasty was conducted, materials similar to those used in adults were used (right, bottom).C + D: Management of patients with hydrocephalus requiring cranioplasty.Most respondents preferred placing a ventriculoperitoneal (VP)-shunt via the contralateral hemisphere (C) when necessary. Additionally, a staged approach was predominantly favored, where cranioplasty (CP) is performed first, followed by VP-shunt placement if required (D).

See this image and copyright information in PMC

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The current state of cranioplasty in Europe - Results from a European cranioplasty survey

Collaborators

Affiliations

The current state of cranioplasty in Europe - Results from a European cranioplasty survey

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

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