Article
Clinical Neurology
Carole S. L. Spake, Rachna Goli, Dardan Beqiri, Joseph W. Crozier, Deus J. Cielo, Petra M. Klinge, Konstantina Svokos, Albert S. Woo
Summary: This study retrospectively analyzed the progression of bone flap resorption (BFR) following autologous cranioplasty (CP) and identified potential risk factors. The results showed that BFR progressed linearly and continuously over time, with a resorption rate of 82% at our institution. Risk factors for accelerated BFR included flap fragmentation, younger age, and absence of diabetes.
WORLD NEUROSURGERY
(2022)
Review
Clinical Neurology
Jack Henry, Michael Amoo, Adam Murphy, David P. O'Brien
Summary: Following cranioplasty, TBI patients have a higher risk of aBFR and re-operation, which may be partially mitigated by using alloplastic materials.
ACTA NEUROCHIRURGICA
(2021)
Review
Clinical Neurology
Francesco Signorelli, Martina Giordano, Valerio Maria Caccavella, Eleonora Ioannoni, Camilla Gelormini, Anselmo Caricato, Alessandro Olivi, Nicola Montano
Summary: Decompressive craniectomy (DC) is effective in controlling increasing intracranial pressure caused by traumatic brain injury (TBI) and stroke. Subsequent cranioplasty (CP) has the potential to improve overall neurological function. However, the use of autologous bone flap (ABF) carries the risk of aseptic bone flap resorption (BFR) and other complications.
NEUROSURGICAL REVIEW
(2022)
Article
Clinical Neurology
Tommi K. Korhonen, Jussi P. Posti, Jaakko Niinimaki, Willy Serlo, Niina Salokorpi, Sami Tetri
Summary: The objective of this study was to evaluate the reliability of the Oulu Resorption Score (ORS) and assess the temporal progression of bone flap resorption after autologous cranioplasty.
CLINICAL NEUROLOGY AND NEUROSURGERY
(2022)
Editorial Material
Medicine, General & Internal
Shankar Gopinath
Summary: Traumatic acute subdural hematomas often require emergency evacuation of the blood clot to prevent further cerebral compression and its consequences. After clot removal, the decision whether to replace the bone flap (craniotomy) or not (decompressive craniectomy) is crucial for neurosurgeons. In certain situations, the decision is relatively straightforward, such as in older individuals with atrophic brains or patients with massively swollen brains, where the bone flap should or should not be replaced.
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
Review
Clinical Neurology
David Shepetovsky, Gianluca Mezzini, Lorenzo Magrassi
Summary: This study investigated the relationship between complications after cranioplasty (CP) and the initial injury, showing that TBI patients have increased odds of bone flap resorption (BFR) and infection after CP. This highlights the importance of implementing new strategies to prevent these complications in TBI patients.
NEUROSURGICAL REVIEW
(2021)
Review
Clinical Neurology
Baris Ozoner
Summary: Cranioplasty has the potential to enhance neurological recovery in severe traumatic brain injury patients by improving brain perfusion and restoring regular cerebrospinal fluid dynamics. Early cranioplasty and the use of both autologous and exogenous materials are likely beneficial for neurological recovery. Recent findings suggest the enhancing effect of cranioplasty on neurological recovery in TBI patients.
CURRENT NEUROLOGY AND NEUROSCIENCE REPORTS
(2021)
Review
Clinical Neurology
David S. Hersh, Hanna J. Anderson, Graeme F. Woodworth, Jonathan E. Martin, Yusuf M. Khan
Summary: Autologous bone flap is generally preferred for pediatric cranioplasty due to its natural biocompatibility and low rejection risk, but pediatric patients are more likely to experience delayed bone resorption, leading to the need for revision surgery.
OPERATIVE NEUROSURGERY
(2021)
Article
Clinical Neurology
Vicente Mirabet, Daniel Garcia, Amparo Roca, Arnold R. Quiroz, Joan Anton, Miguel Rodriguez-Cadarso, Dolores Ocete, Lucas Aranda, Ana Melero, Antonio J. Guillot, Nuria Yague, Isabel Guillen, Carlos Botella
Summary: This study retrospectively analyzed data from 74 patients who underwent cranioplasty with cryopreserved autologous bone after decompressive craniectomy. The study found that pediatric patients had a significantly higher rate of hydrocephalus compared to adults, and the overall rate of bone flap resorption was 21.6%. Surgical site infection after cranioplasty was detected in 6.8% of patients, and there was no correlation between infection and previous microbiological-positive culture during processing. Vancomycin was the only antibiotic detected in the supernatant where the bone was incubated.
WORLD NEUROSURGERY
(2021)
Article
Clinical Neurology
Vicente Mirabet, Daniel Garcia, Amparo Roca, Arnold R. Quiroz, Joan Anton, Miguel Rodriguez-Cadarso, Dolores Ocete, Lucas Aranda, Ana Melero, Antonio J. Guillot, Nuria Yague, Isabel Guillen, Carlos Botella
Summary: This study retrospectively analyzed data from 74 patients who underwent cranioplasty with cryopreserved autologous bone after decompressive craniectomy. It found that pediatric patients had a higher rate of hydrocephalus compared to adults, and the overall rate of bone flap resorption was 21.6% with a postoperative infection rate of 6.8%.
WORLD NEUROSURGERY
(2021)
Article
Clinical Neurology
Philippe Schucht, Andreas Nowacki, Armin Osmanagic, Michael Murek, Werner J. Z'Graggen, Matteo Montalbetti, Juergen Beck, Lennart Stieglitz, Andreas Raabe
Summary: This study aimed to evaluate the feasibility of using space-expanding flaps to protect the brain during decompressive hemicraniectomy (DCE) for malignant infarction of the medial cerebral artery. The results showed that the concurrent use of space-expanding flaps was safe and effective in reducing brain shift and preventing complications.
JOURNAL OF NEUROSURGERY
(2023)
Article
Clinical Neurology
Teodor Svedung Wettervik, Samuel Lenell, Per Enblad, Anders Lewen
Summary: Decompressive craniectomy (DC) and cranioplasty (CP) surgeries in traumatic brain injury patients have a high risk of complications, leading to additional neurosurgery in about one third of cases. The use of synthetic CP materials may decrease the risk of reoperation, but special care with hemostasis is required.
WORLD NEUROSURGERY
(2021)
Article
Clinical Neurology
Mehdi Shafiei, Arman Sourani, Masih Saboori, Bahram Aminmansour, Saeid Mahram
Summary: The study found that using cryopreservation method instead of subcutaneous pocketing method before cranioplasty increased the risk of bone flap infection and bone flap resorption rate.
JOURNAL OF CLINICAL NEUROSCIENCE
(2021)
Article
Clinical Neurology
Zhiji Tang, Kun Hu, Ruijin Yang, Mingang Zou, Ming Zhong, Qiangliang Huang, Wenjin Wei, Qiuhua Jiang
Summary: This study developed and validated a risk-prediction nomogram to predict a 6-month unfavorable prognosis in traumatic brain-injured patients undergoing primary decompressive craniectomy. By analyzing clinical data and constructing a prediction model, the study identified several factors including age, Glasgow Score Scale, operative blood loss, completely effaced basal cisterns, intraoperative hypotension, and activated partial thromboplastin time that were associated with unfavorable prognosis.
FRONTIERS IN NEUROLOGY
(2022)
Article
Neurosciences
Hosam Al-Jehani, Abdulaziz Al-Sharydah, Faisal Alabbas, Abdulrazag Ajlan, Wisam Al Issawi, Saleh Baeesa
Summary: The survey found that the perspective on DC among practicing neurosurgeons in Saudi Arabia is not clearly defined, with some variability in surgical practices. It is recommended to develop appropriate TBI guidelines to reduce practice variability and establish a national TBI registry for documenting practices and outcomes.