• Paolo Frassanito, Luca Massimi, Massimo Caldarelli, Gianpiero Tamburrini, and Concezio Di Rocco.
• Pediatric Neurosurgery, Policlinic A. Gemelli, Catholic Medical School, Rome, Italy. paolo.frassanito@gmail.com
• Acta Neurochir (Wien). 2012 May 1;154(5):927-33.

BackgroundDecompressive craniectomy is an effective treatment option in case of refractory intracranial hypertension after severe head injury. The incidence of complications following cranial repair after decompressive craniectomy for traumatic brain injury is not negligible, particularly in infants and young toddlers. However, only a few dedicated papers can be found in the literature.MethodWe describe the complications observed in two boys and one girl under 1 year of age that were treated in the last decade by hemicranial decompressive craniotomy and enlarging hemispheric duraplasty, and subsequent cranial repair by means of autologous bone-flap replacement.FindingsDespite good clinical and neurological outcome, the postoperative clinical course was complicated in all cases by early or late evidence of subdural fluid collections associated to the occurrence of hydrocephalus and causing recurrent dislocation and progressive resorption of the autologous bone flap.ConclusionsInfants less than 1 year old, undergoing decompressive craniectomy after traumatic brain injury, experience a high rate of complications following subsequent cranial repair. Subdural collections and resorption of the autologous bone flap are to be considered as extremely common complications.

12 keywords...

hide…