Optimal timing of autologous cranioplasty after decompressive craniectomy in children

Clinical article

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Object

The object of this study was to determine if early cranioplasty after decompressive craniectomy for elevated intracranial pressure in children reduces complications.

Methods

Sixty-one consecutive cases involving pediatric patients who underwent autologous cranioplasty after decompressive craniectomy for raised intracranial pressure at a single academic children's hospital over 15 years were studied retrospectively.

Results

Sixty-one patients were divided into early (< 6 weeks; 28 patients) and late (≥ 6 weeks; 33 patients) cranioplasty cohorts. The cohorts were similar except for slightly lower age in the early (8.03 years) than the late (10.8 years) cranioplasty cohort (p < 0.05). Bone resorption after cranioplasty was significantly more common in the late (42%) than the early (14%) cranioplasty cohort (p < 0.05; OR 5.4). No other complication differed in incidence between the cohorts.

Conclusions

After decompressive craniectomy for raised intracranial pressure in children, early (< 6 weeks) cranioplasty reduces the occurrence of reoperation for bone resorption, without altering the incidence of other complications.

Article Information

Address correspondence to: Nathan R. Selden, M.D., Ph.D., Department of Neurological Surgery, Oregon Health & Science University, 3303 SW Bond Avenue, Portland, Oregon 97239. email: seldenn@ohsu.edu.

Please include this information when citing this paper: published online August 3, 2012; DOI: 10.3171/2012.6.PEDS1268.

© AANS, except where prohibited by US copyright law.

Headings

Figures

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    Study design inclusion criteria. AVM = arteriovenous malformation; ICP = intracranial pressure.

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