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Functional Outcomes and Complications Following Very Delayed Cranioplasty: Clinical Challenges and Surgical
Halil Olgun Peker1, Gardashkhan Karımzada2
1Department of Neurosurgery University of Altinbas, Bahçelievler Medicalpark Hospital, Istanbul, Türkiye.
World Neurosurgery
|July 2, 2026
Summary
Cranioplasty (CP) more than two years after decompressive craniectomy (DC) is feasible, showing functional recovery and good cosmetic results. Delayed reconstruction does not increase complication rates, despite potential surgical challenges.
Area of Science:
- Neurosurgery
- Plastic Surgery
- Neurology
Background:
- Cranioplasty (CP) after decompressive craniectomy (DC) improves outcomes.
- Early CP is common, but outcomes of very delayed CP (>2 years) are less understood.
Purpose of the Study:
- To assess functional outcomes, complication rates, and surgical challenges of CP performed over 2 years after DC.
Main Methods:
- Retrospective analysis of 42 patients undergoing CP ≥24 months post-DC.
- Functional outcomes measured by Modified Rankin Scale (mRS) and Glasgow Outcome Scale Expanded (GOSE).
- Aesthetic outcomes assessed via Numeric Rating Scale (NRS).
Main Results:
- Functional improvements noted in mRS and GOSE scores post-CP.
- Overall complication rate was 29%, comparable to literature.
- 91% reported favorable cosmetic outcomes; complications included seizures, hematoma, infection, and implant exposure.
Conclusions:
- Very late-stage cranial reconstruction is technically feasible.
- Addressing challenges like muscle atrophy and CSF dynamics is crucial.
- Delayed CP does not appear to increase overall complication rates.
