Methods of intra-operative treatment of cranioplasty in patients with abnormal bone window flap pressure after decompressive craniectomy

• Reduced bone window flap is conducive to the restoration of skull shape.
• Elevated bone window flap for atrophy scalp avoiding postoperative ischemia.
• Preoperative adjustment of bone flap pressure benefits for separating scalp.
• Preoperative adjustment of bone flap pressure reduces postoperative complications.

ObjectiveThis study was performed to investigate the method of cranioplasty in patients with abnormal bone window pressure after decompressive craniectomy.MethodsWe performed a retrospective analysis for 25 cases after decompressive craniectomy in patients with abnormal flap pressure of clinical data.ResultsFlap pressure increased in 15 cases, including 6 cases of hydrocephalus, 5 cases of contralateral subdural effusion, 2 cases of subdural effusion bone window, 2 cases of bone window cystic encephalomalacia communicating with the ventricle; Flap pressure decreased in 10 cases, including 6 cases of hydrocephalus after ventriculoperitoneal shunt, and 4 cases of low intracranial pressure. ALL of patients were treated by appropriate measures to make the operation smoothly.ConclusionOur data suggest that after analysis of the factors for abnormal bone window flap pressure by decompressive craniectomy and symptomatic treatment, the difficulty of operation and operative complications can be reduced.