What question did this study set out to answer?

To assess the long-term outcomes of porous polyethylene cranioplasty in children with large cranial defects.

May 6, 2026

Long-term Outcomes of Porous Polyethylene Cranioplasty for Large Cranial Defects in Children: Assessment of Clinical Results and Cranial Growth

Key Points

To assess the long-term outcomes of porous polyethylene cranioplasty in children with large cranial defects.
Included patients with traumatic brain injury and failed autologous cranioplasty
Evaluated clinical results and cranial growth over a mean follow-up of 6.5 years
Analyzed head circumference and intracranial volume changes
Identified complications and growth patterns post-reconstruction.
Stable coverage and contour without complications in 25 patients
Head circumference increased in all patients, remaining within age-adjusted values
Intracranial volume changes did not always parallel head circumference changes
Notable growth patterns related to underlying brain injury rather than the reconstruction.

Abstract

) were included. The most common cause was traumatic brain injury (19 patients). Eighty-five percent had failed autologous cranioplasty, and 42% had prior infections. At last follow-up (mean = 6.5 years; range = 1.3-14.5 years), 25 patients had stable coverage and contour without complications. One patient required explantation because of iatrogenic causes. Growth analysis of 12 patients (mean follow-up = 9.3 years; range = 5.4-14.5 years) showed HC increased in all cases and remained within the same age-adjusted percentile range as pre-cranioplasty values. ICV increased or remained stable in 9 of 12 patients. In the remaining three patients, HC-ICV discrepancies resulted from inward calvarial thickening concurrent with intrinsic brain abnormalities.ConclusionsPPE cranioplasty appears to be safe for large cranial defects in select pediatric cases. Head circumference growth occurs over time and remains within normative ranges long term, whereas ICV changes do not always parallel HC. This growth pattern appears related to the extent of underlying brain injury rather than the reconstruction itself.

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