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Related Experiment Video

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A Large Lateral Craniotomy Procedure for Mesoscale Wide-field Optical Imaging of Brain Activity

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Published on: May 7, 2017

Dynamic Decompressive Craniotomy with a Novel Reversibly Expandable Plate.

Rohit Khanna^1,2

¹Department of Neurosurgery, Halifax Health, Daytona Beach, Florida, United States.

Journal of Neurological Surgery. Part A, Central European Neurosurgery

|December 1, 2016

Summary

Dynamic craniotomy, using an expandable bone flap fixation plate, significantly controls intracranial pressure (ICP) during increased intracranial volume. This novel approach offers superior ICP management compared to standard craniotomy with fixed plates.

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Area of Science:

Neurosurgery
Biomedical Engineering

Background:

Intracranial hypertension (ICH) poses significant risks in neurosurgery.
Standard craniotomy with fixed bone flaps can limit the brain's ability to accommodate volume changes.

Purpose of the Study:

To evaluate the feasibility of a dynamic craniotomy technique.
To assess a novel reversibly expandable cranial bone flap fixation plate for managing intracranial volume and pressure.

Main Methods:

A dynamic craniotomy model with an expandable plate was compared to standard craniotomy with fixed plates.
Intracranial hypertension compliance was tested in a skull model with progressive increases in intracranial volume.

Main Results:

Dynamic craniotomy demonstrated significantly better ICP control compared to standard craniotomy.
With increasing intracranial volume (360-600 mL), ICP rose from 2.6 to 91.9 mm Hg in standard craniotomy, versus 2.5 to 25 mm Hg in dynamic craniotomy (p < 0.00001).

Conclusions:

Dynamic craniotomy offers superior intracranial pressure management during abrupt increases in intracranial volume.
The expandable fixation plate facilitates outward bone flap migration, enhancing compliance.