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Cranioplasty following decompressive craniectomy: minor surgical complexity but still high periprocedural complication rates

  • Ehab Shiban
  • Nicole Lange
  • Antonia Hauser
  • Ann-Kathrin Jörger
  • Arthur Wagner
  • Bernhard Meyer
  • Jens Lehmberg
Original Article

Abstract

Cranioplasty following decompressive craniectomy is of low surgical complexity, so much so that it has become the “beginners” cranial case. However, these “simple” procedures may have high complication rates. Identification of specific risk factors would allow targeted intervention to lower the complication rates. The aim of this study was to assess the rate of complications and to evaluate potential risk factors. We conducted a review of all patients who underwent cranioplasty in our center following decompressive craniectomy for stroke or brain trauma between 2009 and 2016. One hundred fifty-two patients were identified. Fifty-three percent were male. Mean age was 48 (range 11–78). Median time from craniectomy until cranioplasty was 102 days (range 14–378). The overall rate of complications, such as postoperative bleeding, seizures, postoperative infection, and hydrocephalus, was 30%. The mortality rate was 1%. None of the following potential risk factors was associated with significantly increased risk of periprocedural complications: gender (p = 0.34), age (p = 0.39), cause of initial surgery (p = 0.08), duration of surgery (p = 0.59), time of surgery (0.24), surgical experience (p = 0.17), and time from craniectomy until cranioplasty (p = 0.27). The 30-day complication rate following cranioplasty is high, but serious permanent deficits from these complications were rare. We found no clear predictor for these 30-day complications, which renders its prevention difficult.

Keywords

Cranioplasty Complication rate Risk factor Mortality 

Notes

Funding information

The study was completely financed by the Department of Neurosurgery.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

For this type of study, formal consent is not required.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Neurosurgery, Klinikum rechts der IsarTechnical University MunichMunichGermany

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