Cranioplasty: A Multidisciplinary Approach
Decompressive craniectomy (DC) is an operation where a large section of the skull is removed to accommodate brain swelling. Patients who survive will usually require subsequent reconstruction of the skull using either their own bone or an artificial prosthesis, known as cranioplasty. Cranioplasty re...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-05-01
|
| Series: | Frontiers in Surgery |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2022.864385/full |
| _version_ | 1818212945050468352 |
|---|---|
| author | H. Mee F. Anwar I. Timofeev N. Owens K. Grieve G. Whiting K. Alexander K. Kendrick A. Helmy P. Hutchinson A. Kolias |
| author_facet | H. Mee F. Anwar I. Timofeev N. Owens K. Grieve G. Whiting K. Alexander K. Kendrick A. Helmy P. Hutchinson A. Kolias |
| author_sort | H. Mee |
| collection | DOAJ |
| description | Decompressive craniectomy (DC) is an operation where a large section of the skull is removed to accommodate brain swelling. Patients who survive will usually require subsequent reconstruction of the skull using either their own bone or an artificial prosthesis, known as cranioplasty. Cranioplasty restores skull integrity but can also improve neurological function. Standard care following DC consists of the performance of cranioplasty several months later as historically, there was a concern that earlier cranioplasty may increase the risk of infection. However, recent systematic reviews have challenged this and have demonstrated that an early cranioplasty (within three months after DC) may enhance neurological recovery. However, patients are often transferred to a rehabilitation unit following their acute index admission and before their cranioplasty. A better understanding of the pathophysiological effects of cranioplasty and the relationship of timing and complications would enable more focused patient tailored rehabilitation programs, thus maximizing the benefit following cranioplasty. This may maximise recovery potential, possibly resulting in improved functional and cognitive gains, enhancement of quality of life and potentially reducing longer-term care needs. This narrative review aims to update multi-disciplinary team regarding cranioplasty, including its history, pathophysiological consequences on recovery, complications, and important clinical considerations both in the acute and rehabilitation settings. |
| first_indexed | 2024-12-12T05:56:27Z |
| format | Article |
| id | doaj.art-94454df0555741f09b60392cbe115244 |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-12-12T05:56:27Z |
| publishDate | 2022-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-94454df0555741f09b60392cbe1152442022-12-22T00:35:33ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2022-05-01910.3389/fsurg.2022.864385864385Cranioplasty: A Multidisciplinary ApproachH. Mee0F. Anwar1I. Timofeev2N. Owens3K. Grieve4G. Whiting5K. Alexander6K. Kendrick7A. Helmy8P. Hutchinson9A. Kolias10Division of Rehabilitation Medicine, Department of Clinical Neurosciences, University of Cambridge & Addenbrooke’s Hospital, Cambridge, UKDivision of Rehabilitation Medicine, Department of Clinical Neurosciences, University of Cambridge & Addenbrooke’s Hospital, Cambridge, UKDivision of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge & Addenbrooke’s Hospital, Cambridge, UKDivision of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge & Addenbrooke’s Hospital, Cambridge, UKDivision of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge & Addenbrooke’s Hospital, Cambridge, UKDivision of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge & Addenbrooke’s Hospital, Cambridge, UKDivision of Rehabilitation Medicine, Department of Clinical Neurosciences, University of Cambridge & Addenbrooke’s Hospital, Cambridge, UKDivision of Rehabilitation Medicine, Department of Clinical Neurosciences, University of Cambridge & Addenbrooke’s Hospital, Cambridge, UKDivision of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge & Addenbrooke’s Hospital, Cambridge, UKDivision of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge & Addenbrooke’s Hospital, Cambridge, UKDivision of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge & Addenbrooke’s Hospital, Cambridge, UKDecompressive craniectomy (DC) is an operation where a large section of the skull is removed to accommodate brain swelling. Patients who survive will usually require subsequent reconstruction of the skull using either their own bone or an artificial prosthesis, known as cranioplasty. Cranioplasty restores skull integrity but can also improve neurological function. Standard care following DC consists of the performance of cranioplasty several months later as historically, there was a concern that earlier cranioplasty may increase the risk of infection. However, recent systematic reviews have challenged this and have demonstrated that an early cranioplasty (within three months after DC) may enhance neurological recovery. However, patients are often transferred to a rehabilitation unit following their acute index admission and before their cranioplasty. A better understanding of the pathophysiological effects of cranioplasty and the relationship of timing and complications would enable more focused patient tailored rehabilitation programs, thus maximizing the benefit following cranioplasty. This may maximise recovery potential, possibly resulting in improved functional and cognitive gains, enhancement of quality of life and potentially reducing longer-term care needs. This narrative review aims to update multi-disciplinary team regarding cranioplasty, including its history, pathophysiological consequences on recovery, complications, and important clinical considerations both in the acute and rehabilitation settings.https://www.frontiersin.org/articles/10.3389/fsurg.2022.864385/fullcranioplastymultidisciplinary approachrehabilitationtraumatic brain injurystroke |
| spellingShingle | H. Mee F. Anwar I. Timofeev N. Owens K. Grieve G. Whiting K. Alexander K. Kendrick A. Helmy P. Hutchinson A. Kolias Cranioplasty: A Multidisciplinary Approach Frontiers in Surgery cranioplasty multidisciplinary approach rehabilitation traumatic brain injury stroke |
| title | Cranioplasty: A Multidisciplinary Approach |
| title_full | Cranioplasty: A Multidisciplinary Approach |
| title_fullStr | Cranioplasty: A Multidisciplinary Approach |
| title_full_unstemmed | Cranioplasty: A Multidisciplinary Approach |
| title_short | Cranioplasty: A Multidisciplinary Approach |
| title_sort | cranioplasty a multidisciplinary approach |
| topic | cranioplasty multidisciplinary approach rehabilitation traumatic brain injury stroke |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2022.864385/full |
| work_keys_str_mv | AT hmee cranioplastyamultidisciplinaryapproach AT fanwar cranioplastyamultidisciplinaryapproach AT itimofeev cranioplastyamultidisciplinaryapproach AT nowens cranioplastyamultidisciplinaryapproach AT kgrieve cranioplastyamultidisciplinaryapproach AT gwhiting cranioplastyamultidisciplinaryapproach AT kalexander cranioplastyamultidisciplinaryapproach AT kkendrick cranioplastyamultidisciplinaryapproach AT ahelmy cranioplastyamultidisciplinaryapproach AT phutchinson cranioplastyamultidisciplinaryapproach AT akolias cranioplastyamultidisciplinaryapproach |