Safety and Efficacy of Early Cranioplasty after Decompressive Craniectomy in Traumatic Brain Injury Patients

Large cranial defects can result from decompressive craniectomy performed for rapid relief of intractable intracranial hypertension. Decompressive craniectomy reduces the risk of death in patients experiencing severe brain edema. However, patients with large cranial defects may experience complications, including sinking flap syndrome and syndrome of the trephined. A large cranial defect is one of the indications for cranioplasty, and, according to prior practice, this procedure is commonly performed 3-6 months after craniectomy because of infection risks or unresolved brain swelling. Recently, the purpose of cranioplasty has changed, from cosmetic or protective effects to therapeutic effects. We performed early cranioplasty in an effort to diminish complications from large cranial defects. The aim of this study was to assess the safety and efficacy of early cranioplasty after decompressive craniectomy. Considering the hospitalization periods and complications that proceed from large cranial defects, another goal of this study is the prompt reintegration of these patients into their normal living environments.