Craniectomy
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A craniectomy is a common neurosurgical procedure wherein which a portion of the skull is resected, but not put back (cf. craniotomy in which the bone flap is re-attached to the surgical defect) 1. The defect is usually covered over with a skin flap. If the defect is closed by a prosthetic covering then it is known as a cranioplasty.
Indications
Craniectomies are frequently performed to decompress the intracranial contents in patients with elevated intracranial pressures 2-4, in which case they might be termed a decompressive craniectomy.
In particular a craniectomy is often favoured in those requiring posterior fossa surgery to avoid problems of post-operative swelling in this region.
- elevated intracranial pressure
- acute trauma
- infarctions
- intracranial haemorrhage
- cranial access for tumour resection
- resection of infected bone flaps following previous craniotomy
- resection of calvarial bone infiltrated by tumour
Complications
Non-specific
- infections of the surgical site
- subdural and subgaleal hygromas
Craniectomy-specific
- extracranial herniation
- external brain tamponade (rare)
- paradoxical herniation
- trephine (sinking skin flap) syndrome
-<p>A <strong>craniectomy</strong> is a common neurosurgical procedure where a portion of the skull is resected, but not put back (cf. <a title="Craniotomy" href="/articles/craniotomy">craniotomy</a>) <sup>1</sup>. The defect is usually covered over with a skin flap. If the defect is closed by a prosthetic covering then it is known as a <a title="Cranioplasty" href="/articles/cranioplasty">cranioplasty</a>.</p><h4>Indications</h4><p>Craniectomies are frequently performed to decompress the intracranial contents in patients with <a title="Elevated intracranial pressures" href="/articles/raised-intracranial-pressure">elevated intracranial pressures</a> <sup>2-4</sup>, in which case they might be termed a decompressive craniectomy.</p><p>In particular a craniectomy is often favoured in those requiring posterior fossa surgery to avoid problems of post-operative swelling in this region.</p><ul>- +<p>A <strong>craniectomy</strong> is a common neurosurgical procedure in which a portion of the skull is resected, but not put back (cf. <a href="/articles/craniotomy">craniotomy</a> in which the bone flap is re-attached to the surgical defect) <sup>1</sup>. The defect is usually covered over with a skin flap. If the defect is closed by a prosthetic covering then it is known as a <a href="/articles/cranioplasty">cranioplasty</a>.</p><h4>Indications</h4><p>Craniectomies are frequently performed to decompress the intracranial contents in patients with <a href="/articles/raised-intracranial-pressure">elevated intracranial pressures</a> <sup>2-4</sup>, in which case they might be termed a decompressive craniectomy.</p><p>In particular a craniectomy is often favoured in those requiring posterior fossa surgery to avoid problems of post-operative swelling in this region.</p><ul>
-</ul><h4>Complications</h4><h6>Non-specific</h6><ul><li> </li></ul><h6>Craniectomy-specific</h6><ul>- +</ul><h4>Complications</h4><h6>Non-specific</h6><ul>
- +<li>infections of the surgical site</li>
- +<li>subdural and subgaleal hygromas</li>
- +</ul><h6>Craniectomy-specific</h6><ul>
-<li>external brain tamponade</li>- +<li>external brain tamponade (rare)</li>
-<a title="Trephined syndrome" href="/articles/paradoxical-brain-herniation">trephine</a> (sinking skin flap) syndrome</li>-</ul><h4> </h4>- +<a href="/articles/paradoxical-brain-herniation">trephine</a> (sinking skin flap) syndrome</li>
- +</ul>
References changed:
- 1. William Alexander Newman Dorland. Dorland's Illustrated Medical Dictionary. (2018) <a href="https://books.google.co.uk/books?vid=ISBN9781416023647">ISBN: 9781416023647</a><span class="ref_v4"></span>
- 2. Haber MA, Abd-El-Barr M, Gormley W, Mukundan S, Sodickson AD, Potter CA. Neurosurgical complications: what the radiologist needs to know. (2019) Emergency radiology. 26 (3): 331-340. <a href="https://doi.org/10.1007/s10140-019-01672-5">doi:10.1007/s10140-019-01672-5</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/30761443">Pubmed</a> <span class="ref_v4"></span>
- 3. Chughtai KA, Nemer OP, Kessler AT, Bhatt AA. Post-operative complications of craniotomy and craniectomy. (2019) Emergency radiology. 26 (1): 99-107. <a href="https://doi.org/10.1007/s10140-018-1647-2">doi:10.1007/s10140-018-1647-2</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/30255407">Pubmed</a> <span class="ref_v4"></span>
- 4. Sinclair A & Scoffings D. Imaging of the Post-Operative Cranium. Radiographics. 2010;30(2):461-82. <a href="https://doi.org/10.1148/rg.302095115">doi:10.1148/rg.302095115</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/20228329">Pubmed</a>
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Systems changed:
- Central Nervous System
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Craniectomy
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