Delayed cranioplasty by autogenous frozen skull plate after decompressive craniectomy combined with duraplasty

The authors analyzed a group of 15 decompressive craniectomies combined with duraplasty, performed as a primary operation or during reoperations after injuries, tumours, vascular lesions and inflammatory processes. After a time interval of 1-14 month autogenous skull plates were replanted, prepared in the Tissue Centre by freezing. The patients aged 9 to 57 years were followed up on average for 2.5 years (3 months to 4.5 gears) clinically, by X-ray examinations and CT. CT proved particularly useful and made it possible to assess 1. the extent of craniectomy before surgery; 2. To investigate the duraplasty and intracranial conditions after decompression; 3. to investigate the lens-shaped effusion beneath the replanted plate; 4, to assess more accurately the X-ray finding on the skull plate. To ensure the incorporation of the skull plates, their replantation must be made as soon as possible after normalization of intracranial hypertension, usually within 1 to 3 months, in inflammatory conditions within six months after craniectomy. For the sake of stability the plates must be well fixed, specially after drainage operations (shunts). Replantation of autogenous skull plates preserved by freezing proved satisfactory from the clinical aspect.