Optimal timing of autologous cranioplasty after decompressive craniectomy in children.

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.

• Authors: Mark P Piedra, Eric M Thompson, Nathan R Selden, Brian T Ragel, Daniel J Guillaume
• Journal: Journal of neurosurgery. Pediatrics (J Neurosurg Pediatr) Vol. 10 Issue 4 Pg. 268-72 (Oct 2012) ISSN: 1933-0715 [Electronic] United States
• PMID: 22861195 (Publication Type: Journal Article)

Topics

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