Posttraumatic Epilepsy and Early Cranioplasty

I N THE past, cranioplasty has been said to exert a beneficial effect on post t raumat ic epilepsy. For this reason, m a n y surgeons have advocated the early repair of a cranial defect to prevent the occurrence of, or to reduce the frequency of seizures occurring after a head injury. 6,7 On the other hand, some authors have found no convincing evidence of such a beneficial effect. This difference of opinion st imulated our interest in the problem. In a previous study, '4 we have reported upon the course of a series of ~73 men who sustained head injuries during World War I I . The cranial defect was plated in ~05 of these men and left open for one or anoiher reason in the other 68 patients. Sixty per cent of plated patients with post t raumat ic epilepsy and 70 per cent of those with skull defects continued to have seizures 5 to 15 years after the original injury. Cranioplasty per se had little influence upon the development or the course of the epilepsy in this series but, since the defects were repaired some months after injury, it seemed advisable to examine another series of patients, some with early and some with late cranioplasties.