Observational studyNeurosurgical review2025
Cranioplasty complications in severe traumatic brain injury: implications of timing of surgery, implant material and incidence of vetriculomegaly versus Post-Traumatic hydrocephalus.
Observational study in Neurosurgical review, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Optimal timing of ventriculoperitoneal shunt insertion relative to cranioplasty post-decompressive craniectomy: a frequentist network meta-analysis.Acta neurochirurgica · 2026Pooled it
- The cranioplasty equation: the influence of biomaterials, surgical timing, and frailty on optimising success.Neurosurgical review · 2026Article
- Neurosurgical Theatres' Carbon Net Efficiency: A Service Improvement Project Conducted via the Oxford Cranioplasty Pathway.Healthcare (Basel, Switzerland) · 2026Article
- Severe trauma care: advances and future directions in diagnostic and therapeutic techniques and information technology support.Medical review (2021) · 2026Article
- Timing and Outcomes of Cranioplasty After Decompressive Craniectomy: A Systematic Review of Neurological Recovery, Complications, and Predictive Factors.Journal of clinical medicine · 2026Review
- Sinking skin flap syndrome masquerading as Chiari malformation: failed syringomyelia treatment rescued by cranioplasty. Illustrative case.Journal of neurosurgery. Case lessons · 2026Article
- Sleeve cranioplasty: A novel endoscope-assisted cranioplasty technique after decompressive hemicraniectomy.Surgical neurology international · 2026Article
- Autologous skull graft resorption following cranioplasty: a case report and literature review.Frontiers in surgery · 2026Article
- Surgery for post-traumatic hydrocephalus: lessons, challenges and future directions.Frontiers in neurologyReview
- Post-traumatic hydrocephalus in adults: the mechanisms of development, predictors of progression and management strategies. A narrative review and case series analysis.Frontiers in neurologyArticle
- Risk factors predisposing to post-traumatic hydrocephalus.Frontiers in neurologyReview
Corrections and comments
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Authors and funding
31 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background Despite the increasing number of decompressive craniectomy (DC) in neurotrauma, the optimal timing for elective cranioplasty (CP) is still debated. Little is known about the CP complications related to surgery, implant material, and post-traumatic hydrocephalus. Objectives To explore the correlation between CP timing, implant material, and the incidence of postoperative complications in patients undergoing CP after DC for severe head injuries. Materials and methods A retrospective multicenter study was conducted from January 2010 to December 2021 across 9 European neurosurgical centers. A cohort of 4007 patients who underwent CP following DC for severe head injury was analyzed. Timing was categorized as: ultra-early (< 30 days), early (31-90 days), late (> 90 days). Complications were defined according to Clavien-Dindo classification, requiring revision surgery and/or hospital readmissions. Results Among the 4007 patients, 352 (8.8%) had ultra-early CP, 1627 (40.5%), and 2028 (51.7%) had early and late CP respectively. Cerebrospinal fluid (CSF) derangement was more frequently associated with large defects and the incidence of Sinking Skin Flap Syndrome (SSFS). SSFS was more frequently diagnosed in patients undergoing late surgery whereas hydrocephalus and epilepsy were less frequently encountered in the ultra-early and early groups (p < 0,05). The overall complication rate was 24.6% (985 patients) including internal hydrocephalus (20%), infection (18%), external hydrocephalus (15%), epilepsy (15%), acute extradural (14%) or subdural hematomas (10%), and subdural hygroma (8%). CP stabilized CSF derangement in 80% of cases, which did not progress into overt hydrocephalus, whereas 17% with definite diagnosis of post-traumatic hydrocephalus required a Ventriculo-Peritoneal shunt (VPS). Simultaneous CP and VPS led to infections in all cases, regardless of implant material. Conclusion Surgery timing has a greater impact on CP complications than implant material. CSF derangement represents the single most relevant factor influencing the clinical course of patients undergoing CP.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.