Acta Neurochirurgica

, Volume 147, Issue 3, pp 279–281

Improved brain protection at decompressive craniectomy – a new method using Palacos R-40 (methylmethacrylate)


  • S. Boström
    • Department of NeurosurgeryUniversity Hospital
  • L. Bobinski
    • Department of NeurosurgeryUniversity Hospital
  • P. Zsigmond
    • Department of NeurosurgeryUniversity Hospital
  • A. Theodorsson
    • Department of NeurosurgeryUniversity Hospital
Technical Note

DOI: 10.1007/s00701-004-0480-4

Cite this article as:
Boström, S., Bobinski, L., Zsigmond, P. et al. Acta Neurochir (Wien) (2005) 147: 279. doi:10.1007/s00701-004-0480-4


A new method is described for protecting the brain after decompressive craniectomy in which a temporary methylmethacrylate flap is formed, somewhat larger than the original bone flap, thus gaining “extra” volume for the oedematous brain in which to expand.

The present procedure was developed as a part of ordinary clinical practice particularly in response to demands from the NICU staff and our colleagues at other clinics who were responsible for the care of the patient in the post NICU period. They made us keenly aware that these patients frequently lack optimal co-ordination and balance and therefore run an increased risk of trauma to the unprotected brain when falling. This prompted us to develop a method for brain protection after decompressive craniectomy aiding in the care and rehabilitation until the final installation of the patient’s own bone flap can be performed.

Keywords: Decompressive craniectomy; malignant brain oedema; bone-flap; Palacos R-40.

Copyright information

© Springer-Verlag/Wien 2005