Outcomes of cranioplasty from a tertiary hospital in a developing country

Prasad, Lakshmi G and Menon, Girish R and Kongwad, Lakshman I and Kumar, Vinod (2020) Outcomes of cranioplasty from a tertiary hospital in a developing country. Neurology India, 68 (1). pp. 63-70. ISSN 0028-3886

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Abstract

Introduction: Although cranioplasty (CP) is a straight forward procedure, it may result in a significant number of complications. These include infections, seizures, intracranial hematomas, and others. Many reports have stated that early CP is associated with higher complications; however, more recent articles have contradicted this opinion. We intend to share our experience and results on outcomes of CP from our university hospital. Materials and Methods: This is a 3‑year retrospective analysis of patients undergoing CP. Demographic profile, etiology of decompressive craniectomy (DC), DC‑CP interval, operative details, complications, and follow‑up data were analyzed. Correlation of complications with timing of CP and other factors was studied to look for statistical significance. Results: A total of 93 cases were analyzed. The majority were traumatic and ischemic stroke etiologies. There were eight open/compound head injuries (HIs). Eleven were bilateral and the rest unilateral cases. The mean and median CP interval were 8.5 weeks (range 4–28 weeks) and 8 weeks, respectively. All patients received 48 h to up to 5 days of postoperative antibiotics. Ten complications (10.7%) were noted (including one death). Poor Glasgow Outcome Scale at CP was the only statistically significant factor associated with higher complication rates. There was no statistical difference with respect to gender, CP material, and etiology; however, early CP had slightly fewer complications. Conclusion: Patients with poor neurological condition at the time of CP have a significantly higher risk of complications. Contrary to earlier reports, early CP (<12 weeks) was not associated with higher complications but rather fewer complications than delayed procedures. Adherence to a few simple steps may help reduce these complications.

Item Type: Article
Uncontrolled Keywords: Complications; cranioplasty; decompressive craniectomy; delayed; early CP infections; timing.
Subjects: Medicine > KMC Mangalore > Neuro Surgery
Depositing User: KMC Library
Date Deposited: 02 Jul 2020 04:08
Last Modified: 02 Jul 2020 04:08
URI: http://eprints.manipal.edu/id/eprint/155197

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