gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

Complications and revision rate of cranioplasty following decompressive craniectomy

Komplikationen und Revisionsrate nach Kranioplastie

Meeting Abstract

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  • corresponding author M. Budde - Klinik für Neurochirurgie, Campus Kiel, Universitätsklinikum Schleswig-Holstein, Kiel
  • M. J. Fritsch - Klinik für Neurochirurgie, Campus Kiel, Universitätsklinikum Schleswig-Holstein, Kiel
  • H. M. Mehdorn - Klinik für Neurochirurgie, Campus Kiel, Universitätsklinikum Schleswig-Holstein, Kiel

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocFR.01.10

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2007/07dgnc065.shtml

Published: April 11, 2007

© 2007 Budde et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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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.