Early Cranioplasty after Decompressive Craniectomy in Patients with Severe Traumatic Brain Injury

Background Cranioplasty is performed after decompressive craniectomy (DC) mainly for protection of the brain and cosmetic purposes. Furthermore, cranioplasty may also improve neuronal and cognitive functions. Despite cranioplasty is a common procedure, the proper timing for cranioplasty is still debatable. Purpose:This study aims at evaluating the impact of timing of cranioplasty after DC on functional and surgical outcomes. Material and methodsThis retrospective study included patients who underwent cranioplasty after DC for severe traumatic brain injury. Patients were divided into two groups based on the time to cranioplasty, either within 2 months (early group) or after 2 months from the initial DC (late group). Patients’ demographics, operative details, postoperative complications, and neurological status at the final visit were collected. Disability Rating Scale (DRS) and Glasgow outcome score (GOS) were used to evaluate the functional outcome.ResultsSixty-two patients were included in this study ,44 males and 18 females, and the mean age was (33.2±15.1). 36 patients (58.1%) were included in the late group, while 26 patients (41.9%) were in the early group. The mean GOS was higher in the early group but wasn’t statistically significant (3.85 ±0.35 vs 3.56 ±0.30; P = 0.12), also there was no statistically significant difference in the DRS between early and late groups (8.85 ±2.05 vs 9.5 ±1.93; P = 0.33). Regarding complications of cranioplasty, there was insignificant difference between the two groups.conclusion Early cranioplasty can be done safely without higher rates of complications, and it may carry better neurological and functional outcomes.