Hiroshi Yokota1, Tadashi Sugimoto2, Mitsuhisa Nishiguchi2, Hiroyuki Hashimoto2. 1. Department of Neurosurgery, Osaka General Medical Center, 3-1-56 Bandai-higashi, Sumiyoshi-ku, Osaka, 558-8558, Japan. hyokota0001@gmail.com. 2. Department of Neurosurgery, Osaka General Medical Center, 3-1-56 Bandai-higashi, Sumiyoshi-ku, Osaka, 558-8558, Japan.
Abstract
PURPOSE: We present the potential usefulness of a greenstick fracture-hinge decompressive craniotomy, a variant of a hinge-craniotomy, as an alternative technique for use with a decompressive craniectomy (DC) in infants. A literature review of hinge-craniotomy procedures and technical variants is also provided, with a focus on complications associated with a DC peculiar to infants and children. METHODS: Illustrative case presentation along with literature review. RESULT: Significant rates of complications associated with a DC and subsequent cranioplasty have been reported, such as bone flap resorption, hydrocephalus, cerebrospinal fluid collection, and infection, especially in infants. A hinge-craniotomy is an older technique reported to have potential usefulness with some modifications, though concerns have been raised about adequate decompression and definitive indications. CONCLUSION: A DC procedure performed in children, especially infants, includes a significantly high risk of various complications; thus, a hinge-craniotomy technique is worthwhile for consideration to avoid such complications. Additional studies are required to clarify whether this technique may contribute to reduce complications related to a DC in infants and children.
PURPOSE: We present the potential usefulness of a greenstick fracture-hinge decompressive craniotomy, a variant of a hinge-craniotomy, as an alternative technique for use with a decompressive craniectomy (DC) in infants. A literature review of hinge-craniotomy procedures and technical variants is also provided, with a focus on complications associated with a DC peculiar to infants and children. METHODS: Illustrative case presentation along with literature review. RESULT: Significant rates of complications associated with a DC and subsequent cranioplasty have been reported, such as bone flap resorption, hydrocephalus, cerebrospinal fluid collection, and infection, especially in infants. A hinge-craniotomy is an older technique reported to have potential usefulness with some modifications, though concerns have been raised about adequate decompression and definitive indications. CONCLUSION: A DC procedure performed in children, especially infants, includes a significantly high risk of various complications; thus, a hinge-craniotomy technique is worthwhile for consideration to avoid such complications. Additional studies are required to clarify whether this technique may contribute to reduce complications related to a DC in infants and children.
Authors: A Taylor; W Butt; J Rosenfeld; F Shann; M Ditchfield; E Lewis; G Klug; D Wallace; R Henning; J Tibballs Journal: Childs Nerv Syst Date: 2001-02 Impact factor: 1.475
Authors: Gerald A Grant; Matthew Jolley; Richard G Ellenbogen; Theodore S Roberts; Joseph R Gruss; John D Loeser Journal: J Neurosurg Date: 2004-02 Impact factor: 5.115