Intracranial Hypotension and Hypertension Associated With Reconstructive Cranioplasty After Decompressive Craniectomy: Report of a Lethal Complication With Recommended Strategies for Future Avoidance. Issue 7 (October 2018)

• Record Type: Journal Article
• Authors: Dalle Ore, Cecilia L.; Abraham, Peter; Burns, Luke P.; Lance, Samuel; Gosman, Amanda; Meltzer, Hal S.
• Is Part Of: Journal of craniofacial surgery. Volume 29:Issue 7(2018)
• Publication Date: 2018-10
• Subjects: Cerebral edema -- cranioplasty -- decompressive craniectomy -- negative pressure differential theory; Facial bones -- Surgery -- Periodicals; Skull -- Surgery -- Periodicals; Face -- Surgery -- Periodicals; Surgery, Plastic -- Periodicals; 617.52
• DOI: 10.1097/SCS.0000000000004706
• Languages: English
• ISSNs: 1049-2275

Abstract

Abstract : Abstract: Reconstructive cranioplasty can be associated with many complications and add to the not insignificant potential risks associated with decompressive craniectomy. In the setting of post-traumatic hydrocephalus, treatment with a ventriculoperitoneal (VP) shunt prior to reconstructive cranioplasty likely increases these risks even further. The authors report a case of a 17-year-old male with a history of a severe closed head injury who initially suffered a life-threatening complication associated with intracranial hypotension after cranioplasty only to succumb to malignant intracranial hypertension following a second cranioplasty attempt. To our knowledge, this is the first description of a single patient developing both these disparate complications after reconstructive cranioplasty and emphasizes the likely synergistic hazards involved with decompressive craniectomy in the setting of a VP shunt in particular and the overall myriad potential complications that may be associated with reconstructive cranioplasty in general.