Reduction cranioplasty for craniocerebral disproportion due to chronic subdural hematoma in infants. A technical report.

Advanced craniocerebral disproportion due to chronic subdural hematoma in infants which is resistant to conventional treatments requires reduction cranioplasty as the last resort. The present paper deals with our experience with two such cases originated from head injury. Since the volume of the hematoma cavity was calculated based on the pre-operative CT scans, we devised a mathematical formula to design how the cranial vault could be reconstructed for reduction. This enabled us to pre-determine the extent of cranial reduction which was tailored to each patient. Furthermore, the present methodology is characterized by the modification that the midline bone strip overlying the superior sagittal sinus was shortened at its anterior end and bent down using the posterior end as a hinge. Since the follow-up results were favorable, this technique of reduction cranioplasty is reported in detail.