Multidimensional evaluation of prosthetically rehabilitated\cranial defects using key behavior change inventory

Defects of the cranial vault can result from the decompressive craniectomy secondary to trauma, cerebral infections, resection of intracranial processes, or bone invading skin tumors. Reconstruction of the cranial vault not only provides protection and esthetic reasons but also maintains and restores physiological circulatory system of the cerebrum essential for the regulation of intracranial pressure. This paper presents prosthetic rehabilitation of two patients, who suffered head injury resulting in extensive frontoparieto temporal defects that induced symptoms such as headache, fatigue, loss of concentration, loss of memory, and depression. Along with the physical dysfunction and disfigurement, the injury resulted in a deep psychological impact on overall well-being and self-esteem of the patient as well as the close family members. The patients were prosthetically rehabilitated with custom-made heat polymerized polymethyl methacrylate cranial prosthesis and the assessment of postrehabilitation outcome was done using a specific measurement tool; key behaviors change inventory (KBCI) a 64-item questionnaire that evaluates executive, interpersonal, and emotional functioning behaviors following traumatic brain injury. Rehabilitation resulted in the restoration of form, function, and esthetics along with the improvement in psychological status and general health as reflected in KBCI scores posttreatment. Based on the posttreatment scores obtained in the cases under study, it is suggested that KBCI may serve as an important prognostic tool for the assessment of treatment outcomes.