Artikel
Complications and revision rate of cranioplasty following decompressive craniectomy
Komplikationen und Revisionsrate nach Kranioplastie
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Veröffentlicht: | 11. April 2007 |
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Objective: Cranioplasty is considered a relatively safe procedure for cosmetic and brain protective purposes following a decompressive craniectomy due to severe head injury or stroke. There are limited data available on the possible complications and revision rate.
Methods: We retrospectively evaluated 91 consecutive patients, who had undergone cranioplasty between January 2000 and December 2004 in our department. The follow-up ranged from 7 to 64 months (mean 36 months). The indication for craniectomy was posttraumatic brain edema (n=34), ischemia following SAH (n=24), primary stroke (n=22), complications of brain tumor treatment (e.g. infection, edema, mass effect) (n=9), meningitis / septic venous thrombosis (n=2). Cranioplasty was performed 7 months (5 days-12 months) following craniectomy. For cranioplasty the following materials were utilized: autologous calvarium (n=61), bone cement (n=23), solid titanium (n=2), a combination of autologous bone and titanium (n=4), a combination of autologous bone and bone cement (n=1).
Results: Surgical revision following cranioplasty was required in 14 patients (15%). The mean time interval between surgery and revision was 182 days (2-675 days). The reason for revision was instability and partial movement (n=6), infection (n=4), epidural haematoma (n=3) and residual / recurrent brain swelling (n=1). A second revision had to be performed in 4 out of the 14 patients (28% of the revised patients).
Conclusions: Cranioplasty has a complication and revision rate of 15%. The most significant complications in our patient series were instability, infection and epidural haematoma.