Cranioplasty

Overview

A surgical technique called cranioplasty is used to fix a defect in the skull. The skull is the bony structure that envelops and safeguards the brain. A surgeon performing a cranioplasty will replace a piece of your skull, reshape your skull, or fix the damage on your skull.

Typically, this kind of surgery occurs after:

• Growth abnormality
• Head trauma
• Cranial surgery in the past

Cranioplasty might be necessary following certain kinds of craniectomies or other brain surgeries. When it is safe to undergo a cranioplasty and whether you are a candidate for the procedure will be communicated to you by your surgeon.

Reasons for undergoing cranioplasty

Cranioplasty is indicated for the following conditions:

• Birth defects, or congenital conditions.
• Injuries sustained after a stressful event.
• Injuries sustained from a traumatic incident.
• Irregularities of the skull shape (cosmetic flaws).
• The part of your skull where there may be a chance of brain damage.
• A hole or defect in your skull from prior surgery.
• Treatment for headaches brought on by prior injuries or surgeries.

Risks

Research indicates that the probability of a risk or complication after a cranioplasty treatment is around forty percent. The likelihood of complications following surgery depends on the condition your surgeon had to treat and on your overall health. The following are the most typical post-cranioplasty complications:

• Blood clot
• Infection
• Brain injury
• Pneumonia

Following a cranioplasty, the following complications may be fatal:

• Seizure
• Stroke
• Hydrocephalus

Before the procedure

Your surgeon will examine you physically and go over your entire medical history with you before a cranioplasty. In order to get you ready for surgery, they will schedule testing, which may include:

• Blood tests
• X-ray
• Magnetic Resonance Imaging (MRI)
• Computed Tomography (CT) scan.

Before surgery, your surgeon will choose which material is best to utilize to repair your skull. In order to precisely measure and fabricate a prosthetic that fits the defect or damaged part of the skull, specialized imaging examinations can be required.

Before surgery, your surgeon may advise you to adjust your medication. If you take blood thinners on a regular basis, you might need to discontinue using them. Medication should not be stopped until your doctor gives the okay. To lower your risk of infection or surgical problems, your surgeon may also advise you to take antibiotics or anticonvulsants.

You must cut back on or give up using tobacco products and alcoholic beverages at least one week prior to surgery and for a few weeks following it in order to avoid issues that could impair your body’s ability to recuperate.

During the procedure

An anesthesiologist will administer anesthesia to you on the day of the procedure, along with drugs to induce sleep and manage pain.

During the procedure, your surgeon will:

• Scrub your skin and shave any hair away from the area of the incision.
• Create a cut on your skin. Should you have undergone a previous craniectomy, the incision will be made along the same (or a comparable) path.
• The area of your skull that requires treatment can be seen by carefully removing tissue and muscle.
• Use bone, a specially made implant, or another material to fix your skull or replace a missing portion. These materials will be fastened into place with screws and titanium plates.
• Reposition your muscles and tissue over the mended area of your skull.
• Seal off the skin incision.

During a cranioplasty, your surgeon will utilize one of the following materials to repair your skull:

• A portion of your skull removed during an earlier procedure.
• A bone graft—a bone taken from another area of your body.
• A synthetic substance (calcium phosphate, hydroxyapatite) that resembles bone.
• A mesh or plate made of metal (titanium).
• A polyetheretherketone or polymethyl methacrylate implant that is specially made.

Your surgeon will select a material that suits the requirements of the operation while reducing your risk of problems.

The average duration of a cranioplasty is three hours. Depending on what your surgeon needs to do, it can take longer.

After the procedure

You usually spend the night following a cranioplasty in a monitored unit, also known as a step-down unit, so your doctor can keep an eye on your recovery. You will be transferred to a regular hospital bed and monitored for an average of five days (or longer, if necessary) if there are no issues.

After surgery, pain, such as a headache, is possible. You will receive medicine from your doctor to help you feel better and reduce pain. It is crucial to ensure that you rest with your head elevated and supported by pillows.

You will receive imaging scans of your head before you are discharged from the hospital to ensure that everything is healing as it should. Once you are discharged from the hospital, your surgeon will provide you with detailed instructions on how to take care of yourself following surgery. You should take plenty of breaks from physically demanding tasks. Until your doctor gives the all-clear, avoid driving.

Outcome

The length of your recovery depends on the type and extent of your surgery. Following a cranioplasty, recovery typically takes one to three months. For further details on how long it will take you to recover, speak with your doctor.