Reduction cranioplasty for macrocephaly with long-standing hydrocephalus and non-fused fontanelle in Chiari malformation type I

Abstract

Introduction Because hydrocephalus is diagnosed and treated at an early stage in pediatric patients, pediatric neurosurgeons rarely encounter patients with hydrocephalic macrocephaly. There are even fewer cases of infants with long-standing hydrocephalus in whom macrocephaly progresses and is accompanied by skull defect due to malunion of suture lines despite long-term CSF diversion treatment. Case report We report the case of a male infant with Chiari malformation type I who presented with congenital hydrocephalus and occipital encephalocele that progressed to hydrocephalic macrocephaly with frontal skull defect, despite numerous cerebrospinal fluid diversion operations. The patient eventually recovered successfully after reduction cranioplasty.

Role of Cranioplasty in Management of Chiari Malformation

“…The titanium mesh also has the extra preventive accomplishment against re-stenosis at the CVJ by creating a barrier between the musculature and the dura. Choi et al in 2014 described reduction cranioplasty in an infant of congenital HCP, occipital encephalocele with CM1 [55]. Though it was not a conventional posterior fossa decompression surgery the presence of CM1 carries the merit to be mentioned here.…”