Cranioplasty

Cranioplasty is a surgical operation on the repairing of cranial defects caused by previous injuries or operations, such as decompressive craniectomy. It is performed by filling the defective area with a range of materials, usually a bone piece from the patient or a synthetic material. Cranioplasty is carried out by incision and reflection of the scalp after applying anaesthetics and antibiotics to the patient. The temporalis muscle is reflected, and all surrounding soft tissues are removed, thus completely exposing the cranial defect. The cranioplasty flap is placed and secured on the cranial defect. The wound is then sealed

What Does My Doctor Need To Know Before My Cranioplasty?
Let your doctor know if you:
- Have any health problems, including blood-clotting conditions.
- Take blood thinners such as warfarin, aspirin or anti-inflammatory drugs.
- Have allergies to any medications or other substances.
What Are The Risks Associated With Cranioplasty?
As in the case of any surgery, you should discuss the risks with your surgeon, including (but not limited to) the following:
- Infection (which may need to be treated with antibiotics).
- Postoperative blood clot requiring drainage.
- Stroke.
- Seizure.
- Clot in the legs (which rarely can travel to the lungs).
- Complication not related directly to the surgery:
Cranioplasty Risks
All surgical procedures carry some form of risk. The most common risks associated with a cranioplasty include infection, blood clot formation, seizures and stroke. Choosing an experienced surgeon who has performed this procedure many times can lessen the chance of developing a complication after undergoing a cranioplasty.
What Is It Like To Recover From A Cranioplasty?
You will wake up in recovery, and after about an hour you will be transferred to the neurosurgical floor or to the NCCU (neurosurgical intensive care unit). Your nursing staff will continually monitor you for any signs of a complication, and measure your pulse, blood pressure, limb strength and level of alertness. During the first night in the hospital, you will be awakened for these observations.

Operations on the head do not often hurt much, but you may have a headache and will have pain relief pills and injections to ensure you’re comfortable. You may still have a urinary catheter in place from the operation.

In the next day or so, your nurse will remove the IV drip in your arm, and you will be encouraged to walk. Gradually, you will be able to move about normally. Your head bandage will be removed on the second day after surgery.

Most cranioplasty patients spend two to three days in the hospital after surgery. When your care team determines you can get around, shower and dress yourself, you will get a repeat CT scan of your head. If the surgical site looks okay, you will be released and can go home.
Why Might A Doctor Recommend A Cranioplasty?
Cranioplasty might be performed for any of the following reasons:
- Protection: In certain places, a cranial defect can leave the brain vulnerable to damage.
- Function: Cranioplasty may improve neurological function for some patients. In some instances, a customized cranial implant is designed ahead of time to help the surgeon obtain an ideal shape and outcome, as well as to house embedded neuro technologies.
- Aesthetics: A noticeable skull defect can affect a patient’s appearance and confidence.
- Headaches: Cranioplasty can reduce headaches due to previous surgery or injury.
What Happens When I Leave The Hospital?
It may take some time before you feel completely back to normal.
- You will be tired.
- It is common to require a rest in the afternoon.
- You may have intermittent headaches.
- You will schedule appointments for one week and three to four weeks after surgery to have your sutures removed.
- Depending on how quickly you recover from any preoperative disability, you may require rehabilitation.
Contact your surgery team IMMEDIATELY if you notice:
- Increasing headache.
- Fever.
- Seizures.
- Swelling or infection in the wound.
- Fluid leaking from the wound.
Important: DO NOT DRIVE until your doctor says you are ready. You will be assessed a week or two after your surgery to determine if it’s OK for you to drive.
What is a Cranioplasty?
A cranioplasty is a surgical procedure used to correct a defect in a bone of the skull. The defect might be congenital, the result of trauma to the head or a complication from an earlier surgery. A cranioplasty will not only improve the appearance of the head, but also may provide several medical benefits. Strengthening the problem area offers much more thorough protection for the brain. Additionally, those patients experiencing headaches or neurological impairment may find their symptoms are diminished after undergoing a cranioplasty.

Treatments

The Cranioplasty Procedure
A cranioplasty is performed in a hospital setting with the patient under general anesthetic. A portion of the scalp will be shaved and a topical cleanser is applied to prevent infection. The surgeon then makes an incision in the skin to access the skull bones. If the existing bone is intact and undamaged, the surgeon can reshape and reposition it and use special discs as well as titanium plates and screws to secure it in place. It is generally considered optimal to use the patient’s original bone if it remains functional. However, in cases where the bone has been badly damaged or removed, there are several options available. Prior to the surgery, it will be determined exactly what substance will be used to replace the bone. Depending on a number of factors, the surgeon may choose to graft a piece of bone that has been removed from the patient’s rib, skull or pelvis; use a bone substitute made from a synthetic material; or employ an acrylic insert that can be fitted into the defective area. All of these are attached to the nearby bones with titanium plates and screws. Once the bone or grafting material has been properly affixed, the surgeon will close the scalp incision using either sutures or surgical staples. View

The Cranioplasty Procedure

A cranioplasty is performed in a hospital setting with the patient under general anesthetic. A portion of the scalp will be shaved and a topical cleanser is applied to prevent infection. The surgeon then makes an incision in the skin to access the skull bones. If the existing bone is intact and undamaged, the surgeon can reshape and reposition it and use special discs as well as titanium plates and screws to secure it in place.

It is generally considered optimal to use the patient’s original bone if it remains functional. However, in cases where the bone has been badly damaged or removed, there are several options available. Prior to the surgery, it will be determined exactly what substance will be used to replace the bone. Depending on a number of factors, the surgeon may choose to graft a piece of bone that has been removed from the patient’s rib, skull or pelvis; use a bone substitute made from a synthetic material; or employ an acrylic insert that can be fitted into the defective area. All of these are attached to the nearby bones with titanium plates and screws.

Once the bone or grafting material has been properly affixed, the surgeon will close the scalp incision using either sutures or surgical staples.

View

What Happens During A Cranioplasty
In the operating room, you are given a general anesthetic. Once you are asleep, the team positions you so the surgeons have optimal access to the bone defect. The area of the incision is then shaved and prepared with antiseptic, and you are protected by drapes that leave only the surgical area exposed. You will get a local anesthetic, then the surgeon will carefully cut the skin of your scalp and gently separate it into layers, thereby protecting the dura, which covers the brain. The team cleans the edges of surrounding bone and prepares the surface so the bone or implant can be positioned properly in the defect, after which it is secured to the cranial bones with screws, plates or both. With the bone or implant in place, bleeding is controlled, the team moves the scalp back to its original position and closes the incision with nylon suture. You may also have a small suction drain left in place to help remove any excess fluid. The drain will be removed in a few days. View

What Happens During A Cranioplasty

In the operating room, you are given a general anesthetic. Once you are asleep, the team positions you so the surgeons have optimal access to the bone defect. The area of the incision is then shaved and prepared with antiseptic, and you are protected by drapes that leave only the surgical area exposed.

You will get a local anesthetic, then the surgeon will carefully cut the skin of your scalp and gently separate it into layers, thereby protecting the dura, which covers the brain. The team cleans the edges of surrounding bone and prepares the surface so the bone or implant can be positioned properly in the defect, after which it is secured to the cranial bones with screws, plates or both.

With the bone or implant in place, bleeding is controlled, the team moves the scalp back to its original position and closes the incision with nylon suture. You may also have a small suction drain left in place to help remove any excess fluid. The drain will be removed in a few days.

View