Spontaneous Cranial Bone Regeneration After a Craniectomy in an Adult

González-Bonet, Luis Germán

doi:10.1016/j.wneu.2020.12.056

Cited by 12 publications

(8 citation statements)

References 7 publications

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“…[1][2][3][4][5][6] The remaining instances occurred in patients aged 18, 20, and 29, with various mechanisms of injury and patientspecific comorbidities. [7][8][9] Generally, pediatric patients, particularly those under 1 year of age, possess strong osteogenic potential for calvarial regrowth. This is most notably remarked by craniosynostosis literature, in which spontaneous closure of surgical defects is frequently encountered.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Reossification Following Craniectomy in a Pediatric Patient

Soliman

Sobti

Rao

et al. 2022

The Cleft Palate Craniofacial Journal

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Spontaneous reossification following a cranial defect is described by only a few case reports. A 6-month-old male with epidural hematoma underwent decompressive craniotomy, subsequently complicated by scalp abscess requiring removal of the bone flap. On serial outpatient follow-up, the patient demonstrated near-complete resolution of cranial defect over the course of 18 months, thus deferring the need for future cranioplasty. Prior articles have identified this occurrence in children and young adults; however, the present case is the first to report of this phenomenon in an infant less than 1 year of age. A brief review of the literature is provided with the proposed physiologic underpinning for the spontaneous reossification observed. While prior studies propose that recranialization is mediated by contact with the dura mater and pericranium, new investigations suggest that calvarial bone repair is also mediated by stem cells from the suture mesenchyme.

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Section: Discussionmentioning

confidence: 99%

Spontaneous Reossification Following Craniectomy in a Pediatric Patient

Soliman

Sobti

Rao

et al. 2022

The Cleft Palate Craniofacial Journal

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“…González-Bonet, 2021 [13] Female A search of articles published from June 1991 through October 14, 2021, involving skull ossification was conducted via title and abstract search in the Web of Science, PubMed, and CNKI (a local database) databases. The search terms used were as follows: heterotopic ossification (HO), spontaneous bone regeneration, osteogenesis, decompressive craniectomy, and traumatic brain injury.…”

Section: Methodsmentioning

confidence: 99%

“…[16] Some cases cited in this study also suggested that the gentle separation of skin and muscle during the operation to maintain the integrity of blood vessels may be important for skull regeneration. [12,13]…”

Section: Possible Mechanisms and Impact Factors In Spontaneous Skull ...mentioning

confidence: 99%

“…Three possible factors could contribute to spontaneous bone formation after large calvarial defects: pericranium/periosteum, diploe, and dura mater [12,13] ; skull fracture can stimulate latent osteoblasts within the periosteum and on both sides of the defect, [14] thus participating in the subsequent process of bone formation. Dura mater and pericranium/periosteum can enhance the effect of osteogenesis through contact with the graft.…”

Section: Possible Mechanisms and Impact Factors In Spontaneous Skull ...mentioning

confidence: 99%

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Extensive skull ossification after decompressive craniectomy in an elderly patient

Yang¹,

Liang²,

Su³

2022

Medicine

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Rationale: After severe traumatic brain injury, patients often present with signs of increased intracranial hypertension and partially require decompressive craniectomies. Artificial materials are usually required to repair skull defects and spontaneous skull ossification is rarely observed in adults.Patient concerns: This study reported a 64-year-old man was admitted to the hospital with a coma due to a traffic accident.Diagnosis: Emergency computed tomography (CT) examination upon admission showed a left temporo-occipital epidural hematoma with a cerebral hernia and skull fracture.Interventions: The patient underwent urgent craniotomy for hematoma removal and decompression under general anesthesia. The patient was discharged after 1 month of treatment.Outcomes: The patient returned to the hospital for skull repair 145 days after the craniotomy. Pre-operative CT showed island skull regeneration in the skull defect area; therefore, skull repair was postponed after clinical evaluation. Regular follow-up is required. Twenty-three months after surgery, head CT showed that the new skull had completely covered the defect area.Lesson: We collected other 11 similar cases of spontaneous human skull regeneration in a literature search to analyze the possible factors impacting skull regeneration. The analysis of the cases indicated that maintaining the integrity of the periosteum, dura, and blood vessels during craniotomy may play an important role in skull regeneration. Skull regeneration predominantly occurs in young patients with rapid growth and development; therefore, an appropriate postponement of the cranioplasty time under close monitoring could be considered for young patients with skull defects.

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“…Compared to the dipolë, these soft tissues typically have a larger area in direct contact with a cranioplasty implant, and recent studies revealed the significance of these soft tissues in the healing of cranial defects. It is known that pericranium, dura mater, and temporalis possess osteogenic potential [78,166], and cases of spontaneous cranium regeneration similarly emphasise the potential contribution of the intact or carefully reconstructed dura mater and pericranium to the re-ossification at the defective sites [47,49,54]. An intimate integration of a healthy, vascularised scalp with a cranioplasty implant also contributes to greater implant stability and a lower risk of infection [20,106,[167][168][169], while close contact between the dura mater and implant is vital to minimise the interval of dead space and subsequent fluid collection [170].…”

Section: Proper Management Of Surrounding Soft Tissuementioning

confidence: 99%

Biomaterials for Regenerative Cranioplasty: Current State of Clinical Application and Future Challenges

2024

JFB

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Acquired cranial defects are a prevalent condition in neurosurgery and call for cranioplasty, where the missing or defective cranium is replaced by an implant. Nevertheless, the biomaterials in current clinical applications are hardly exempt from long-term safety and comfort concerns. An appealing solution is regenerative cranioplasty, where biomaterials with/without cells and bioactive molecules are applied to induce the regeneration of the cranium and ultimately repair the cranial defects. This review examines the current state of research, development, and translational application of regenerative cranioplasty biomaterials and discusses the efforts required in future research. The first section briefly introduced the regenerative capacity of the cranium, including the spontaneous bone regeneration bioactivities and the presence of pluripotent skeletal stem cells in the cranial suture. Then, three major types of biomaterials for regenerative cranioplasty, namely the calcium phosphate/titanium (CaP/Ti) composites, mineralised collagen, and 3D-printed polycaprolactone (PCL) composites, are reviewed for their composition, material properties, and findings from clinical trials. The third part discusses perspectives on future research and development of regenerative cranioplasty biomaterials, with a considerable portion based on issues identified in clinical trials. This review aims to facilitate the development of biomaterials that ultimately contribute to a safer and more effective healing of cranial defects.

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Spontaneous Cranial Bone Regeneration After a Craniectomy in an Adult

Cited by 12 publications

References 7 publications

Spontaneous Reossification Following Craniectomy in a Pediatric Patient

Spontaneous Reossification Following Craniectomy in a Pediatric Patient

Extensive skull ossification after decompressive craniectomy in an elderly patient

Biomaterials for Regenerative Cranioplasty: Current State of Clinical Application and Future Challenges

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