A retrospective analysis and review of an institution's experience with the complications of cranioplasty

Abstract

Cranioplasty has significant complications. A thorough understanding of factors that contribute to the different types of complications will benefit the management of cranioplasty patients.

Autologous Cranioplasty Post-Operative Surgical Site Infection: Does It Matter if the Bone Flaps were Stored and Handled Differently?

“…The study found that the incidence of SSI in cranioplasty using the autologous bone flap method at the two studied centres was 5.9% in 101 patients within a period of 18 months. This finding is consistent with previously reported rates of infection, ranging between 7% and 22% (10)(11). The rate of postcranioplasty SSI was 5.5% and 6.5% for the cryopreserved bone flaps and the bone flaps stored in the abdominal subcutaneous pocket, respectively.…”

Complications following cranioplasty: incidence and predictors in 348 cases

“…Surgery might produces free radicals, disturb the ionic balance, and manipulate the cerebral parenchyma, all of which have been postulated as mechanisms for postoperative seizure formation. 25,48 In the literature, TBI, hemorrhagic stroke, and neurological deficits before cranioplasty increased the risk of seizures. 25 In our study, we found that male sex, cranioplasty infection, and older age were significantly associated with seizures.…”

“…25,48 In the literature, TBI, hemorrhagic stroke, and neurological deficits before cranioplasty increased the risk of seizures. 25 In our study, we found that male sex, cranioplasty infection, and older age were significantly associated with seizures. Furthermore, seizure itself was significantly associated with death.…”

Anticoagulation for Hypercoagulable Patients Associated with Complications after Large Cranioplasty Reconstruction

“…For example, Lee et al found that an indication of trauma for the primary craniectomy was associated with a higher risk of postoperative seizure (p = 0.03). 7 In addition, Reddy et al discovered that a history of irradiation was the strongest positive predictor of postoperative complications of any type after cranioplasty (OR, 6.91; p < 0.005) and that preoperative infection increased the risk of alloplastic hardware exposure (OR, 3.13; p < 0.05). 9 Likewise, a history of previous osteomyelitic bone flap infection was found to be predictive of major complications in our study (OR, 6.5; p < 0.0001).…”

“…Although several studies have focused on the risk and predictors of infection and bleeding after cranioplasty, [12][13][14][15] research is sparse regarding the predictive factors associated with other types of postoperative complications. 7 Cited positive predictors of complications after cranioplasty include a history of irradiation, preoperative infection, 9 pneumocephalus, 16 nicotine abuse, age older than 60 years, lower Glasgow Outcome Scale, 19 and bifrontal cranioplasty. 20,21 However, despite a large body of research on perioperative anticoagulation, and the growing number of patients diagnosed with thromboembolic disease each year, [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] no study to date has investigated the impact of perioperative anticoagulant therapy on complications following cranioplasty reconstruction.…”