Optimal timing of autologous cranioplasty after decompressive craniectomy in children

J Neurosurg Pediatr. 2012 Oct;10(4):268-72. doi: 10.3171/2012.6.PEDS1268. Epub 2012 Aug 3.

Abstract

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.

MeSH terms

  • Adolescent
  • Bone Resorption*
  • Bone Transplantation*
  • Child
  • Child, Preschool
  • Cohort Studies
  • Decompressive Craniectomy / adverse effects*
  • Female
  • Humans
  • Intracranial Hypertension / etiology
  • Intracranial Hypertension / surgery*
  • Logistic Models
  • Male
  • Plastic Surgery Procedures / adverse effects
  • Plastic Surgery Procedures / methods*
  • Reoperation / statistics & numerical data
  • Retrospective Studies
  • Skull / pathology
  • Skull / surgery*
  • Time Factors
  • Transplantation, Autologous