Efficacy and safety of early cranioplasty, at least within 1 month.

INTRODUCTION: Patients may experience problems, including severe adhesion during skull restoration procedures performed after decompressive craniectomy. Cranioplasty is currently the only solution for these adverse outcomes, although there is no established consensus on optimal surgical timing. Here, we study the efficacy and safety of early cranioplasty performed within 1 month after first surgical decompression.
METHODS: In this study, we retrospectively enrolled 30 patients during a 30-month period. Serial brain computed tomographic scans were obtained to demonstrate relief of brain swelling. During the operative procedure, the efficacy of early cranioplasty was assessed by measuring elapsed operating time, dissection time, and blood loss. Fifteen patients were selected for the control group, all of whom had undergone cranioplasty performed more than 3 months after first decompression.
RESULTS: All primary causes for craniectomy were traumatic in enrolled patients. The mean interval for cranioplasty was 28.6 days after first operation. When compared with the control group, the mean time for dissection was much shorter (15.3 min, P < 0.0001) and estimated blood loss was much smaller (336.67 mL, P < 0.0001) in the early cranioplasty group. No patients experienced surgery-related complications during the 6-month follow-up period.
CONCLUSIONS: Early cranioplasty provides satisfactory securing dissection plane during operative procedures compared with later cranioplasty, without causing additional complications including infection, subdural hygroma, and brain parenchymal damage, in selected cases.