Cranioplasty Following Decompressive Craniectomy

Frontiers in Neurology

Louis-Georges Roumy¹  Kostas Fountas²  Amos Olufemi Adeleye³  Corrado Iaccarino⁵  Angelos G. Kolias⁶ 

[1] Department of Neurosurgery, Humanitas University and Research Hospital, Milan, Italy;Department of Neurosurgery, University Hospital of Larissa, University of Thessaly, Larissa, Greece;Division of Neurological Surgery, Department of Surgery, College of Medicine, University College Hospital, University of Ibadan, Ibadan, Nigeria;Division of Neurosurgery, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom;Emergency Neurosurgery Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy;NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom;Neurosurgery Unit, University Hospital of Parma, Parma, Italy;

关键词: cranioplasty;    decompressive craniectomy;    traumatic brain injury;    cranial reconstruction;    bone flap;    posttraumatic hydrocephalus;   

DOI  :  10.3389/fneur.2019.01357

来源: DOAJ

【 摘 要 】

Cranioplasty (CP) after decompressive craniectomy (DC) for trauma is a neurosurgical procedure that aims to restore esthesis, improve cerebrospinal fluid (CSF) dynamics, and provide cerebral protection. In turn, this can facilitate neurological rehabilitation and potentially enhance neurological recovery. However, CP can be associated with significant morbidity. Multiple aspects of CP must be considered to optimize its outcomes. Those aspects range from the intricacies of the surgical dissection/reconstruction during the procedure of CP, the types of materials used for the reconstruction, as well as the timing of the CP in relation to the DC. This article is a narrative mini-review that discusses the current evidence base and suggests that no consensus has been reached about several issues, such as an agreement on the best material for use in CP, the appropriate timing of CP after DC, and the optimal management of hydrocephalus in patients who need cranial reconstruction. Moreover, the protocol-driven standards of care for traumatic brain injury (TBI) patients in high-resource settings are virtually out of reach for low-income countries, including those pertaining to CP. Thus, there is a need to design appropriate prospective studies to provide context-specific solid recommendations regarding this topic.

【 授权许可】

Unknown