Complications after decompressive craniectomy and cranioplasty

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Abstract

Decompressive craniectomy (DC) and cranioplasty are common operations which appear deceptively straightforward. However, there are many potential pitfalls and complications of these operations most of which can be avoided with an experienced neurosurgeon involved, careful planning, anticipation of the risks, meticulous surgical technique and assiduous post-operative care. This chapter outlines the relevant applied anatomy, the general and specific complications of these operations and presents strategies for avoidance of these complications. The common complications of DC are postoperative haemorrhage, hydrocephalus, delayed subdural effusion and syndrome of the trephined. The common complications of cranioplasty are resorption of the bone flap, subflap hematoms and infection. We advocate early cranioplasty following DC once brain swelling has subsided and before the longer term complications of DC have developed. Paradoxical herniation following DC and massive brain swelling following cranioplasty are uncommon life-threatening complications which the neurosurgeon should be aware of.

Original languageEnglish
Title of host publicationComplications in Neurosurgery
EditorsAnil Nanda
PublisherElsevier
Chapter44
Pages266-273
Number of pages8
Edition1st
ISBN (Electronic)9780323510516
ISBN (Print)9780323509619
DOIs
Publication statusPublished - 31 Oct 2018

Keywords

  • Complications
  • Cranioplasty
  • Decompressive craniectomy
  • Neurosurgery

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