TITLE:
Cranioplasty after Decompressive Craniectomy Caused an Intracerebral Hemorrhage: A Case Report
AUTHORS:
Takayuki Okumoto, Tomito Oji, Kazuo Kishi
KEYWORDS:
Cranioplasty, Rigid Reconstruction, Skull Defect, Intracerebral Hemorrhage, Decompressive Craniectomy
JOURNAL NAME:
Modern Plastic Surgery,
Vol.5 No.3,
July
27,
2015
ABSTRACT: Decompressive
craniectomy is a common practice for patients with intracranial hypertension.
Secondary rigid structural reconstruction following craniectomy can release the
effects of atmospheric pressure on the brain, and the brain can become dilated.
Although some cases with complications induced by cranioplasty, such as
intracranial hematoma, have been reported, no clinical cases with intracerebral
hemorrhage after rigid reconstruction have been reported. This case report
describes a 39-year-old man with a skull defect following clipping with
simultaneous decompressive craniectomy for a subarachnoid hemorrhage. About 25
months later, cranioplasty using a custom-made hydroxyapatite (HAP) ceramic implant
was performed. Immediately after the operation, intracerebral hemorrhage was
detected on the opposite side by computed tomography (CT). However, there were
no physical or neurological findings, the hematoma was completely absorbed
within 3 weeks postoperatively, and the skull retained a good shape. This case
suggests that rigid reconstruction of a skull defect can influence intracranial
conditions, and early postoperative CT is important to detect complications.