Complications of delayed cranial repair after decompressive craniectomy in children less than 1 year old

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Microvascular Decompression: Salient Surgical Principles and Technical Nuances
10:35

Microvascular Decompression: Salient Surgical Principles and Technical Nuances

Published on: July 5, 2011

Paolo Frassanito1, Luca Massimi, Massimo Caldarelli

  • 1Pediatric Neurosurgery, Policlinic A. Gemelli, Catholic Medical School, Rome, Italy. paolo.frassanito@gmail.com

Acta Neurochirurgica
|December 27, 2011
PubMed

Insights

Infants undergoing decompressive craniectomy for traumatic brain injury face high complication rates during cranial repair. Subdural fluid collections and bone flap resorption are common issues in this young population.

Area of Science:

  • Neurosurgery
  • Pediatric Traumatology

Background:

  • Decompressive craniectomy effectively treats intracranial hypertension after severe head injury.
  • Complications after cranial repair post-decompressive craniectomy are significant in infants and young toddlers.
  • Limited literature addresses these specific complications in very young children.

Observation:

  • This study details complications in three infants (two boys, one girl) under one year old.
  • Treatment involved hemicranial decompressive craniotomy, duraplasty, and autologous bone-flap replacement for cranial repair.
  • The observation period spanned the last decade.

Findings:

  • All patients experienced early or late subdural fluid collections post-surgery.
  • Hydrocephalus was associated with these collections.
  • Recurrent dislocation and progressive resorption of the autologous bone flap were observed in all cases.

Implications:

  • Infants under one year undergoing decompressive craniectomy have a high risk of complications after cranial repair.
  • Subdural collections and autologous bone flap resorption are frequent issues.
  • This highlights the need for careful monitoring and potential alternative strategies for cranial repair in this age group.
Abstract

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