How I do it-the posterior question mark incision for decompressive hemicraniectomy

Area of Science:

• Neurosurgery
• Surgical Techniques

Background:

• Decompressive hemicraniectomy (DHC) is a critical neurosurgical procedure with expanding indications.
• Cranioplasty is frequently required for skull reconstruction after DHC.
• The posterior question mark incision is presented as an alternative to traditional flaps.

Purpose of the Study:

• To detail the surgical technique of the posterior question mark incision for cranioplasty.
• To highlight specific considerations and potential pitfalls associated with this approach.
• To provide guidance for neurosurgeons seeking to adopt this incision method.

Main Methods:

• Comprehensive discussion of surgical steps.
• Identification of essential surgical aids.
• Analysis of potential surgical pitfalls.

Main Results:

• The posterior question mark incision is a straightforward and adoptable technique.
• Detailed considerations for its successful implementation are provided.
• The method is presented as a viable alternative to classic trauma flaps.

Conclusions:

• The posterior question mark incision has become the preferred method for cranioplasty in the department.
• This preference is attributed to a lower complication rate compared to anterior question mark incisions.
• The technique facilitates successful skull reconstruction after decompressive hemicraniectomies.