Cranioplasty: Indications, Techniques, and Results by Dragoslav Stula M.D. (auth.)

By Dragoslav Stula M.D. (auth.)

This monograph offers a complete assessment of the scientific adventure in surgical fix of cranial defects which the writer has received in the course of a interval of over ten years. specific difficulties of sufferers present process cranioplasty, comparable to neurological impairments, EEG alterations, adaptations of intracranial strain, and sinking pores and skin flap syndrome are defined and mentioned. the writer offers convincing facts of the significance of cranioplasty in enhancing the standard of lifetime of sufferers with huge and disfiguring cranial defects. regrettably, cranioplasty nonetheless ameliorates purely to a minimum volume the overall in sufferers ache of significant cerebral lesions. i'm confident that this quantity will serve the aim it used to be designed for : that it'll be a such a lot worthy creation into the issues with regards to reconstructive surgical procedure. Basel, August 1984 Otmar Gratzl Contents creation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 A. background of Cranioplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . three B. medical facets of Cranial Bone Defects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 I. beginning of Cranial Defects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 1. obtained Defects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 2. Congenital Defects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . nine three. Demographic and different features of sufferers . . . . . . . . . . . . . . . . . nine II. Neurological and Psychic adjustments ahead of and After Cranioplasty . . . . . . . eleven 1. class of Neurological Deficits and of the outside Flap varieties . . . . . thirteen 2. The "Sinking epidermis Flap Syndrome" . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . sixteen three. The impact of Cranioplasty Upon Neurological and Psychic alterations 17 III. Electroencephalographic (EEG) adjustments in sufferers with Cranial Defects 21 1. EEG Recordings and Casuistic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 2. overview of EEG alterations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 IV. Scintigraphy Findings in sufferers with Cranial Bone Defects . . . . . . . . . . . . 26 1. Casuistic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 2. effects and dialogue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Extra resources for Cranioplasty: Indications, Techniques, and Results

Example text

3. Postoperative Pressure Readings The preoperatively implanted pressure measuring device was not removed during the surgery, and the monitoring was continued postoperatively in the same manner. The pressure normalized itself after the cranioplasty in all patients of the first group, who had an elevated intracranial pressure. 5 mm Hg sank to 11 mm Hg (14 cm H 2 0) postoperatively (Figs. 27 a, b, c). The normalization of intracranial pressure in these patients was paralleled by marked clinical improvement.

Before long, an artificial eye will be prepared by the ophthalmologist II. Contraindications There are not very many contraindications for performing cranioplasty. They could be divided into five groups: raised intracranial pressure and brain prolapse, skin necrosis with consecutive defects, local and generalized infections, cranial defects with communication to the paranasal sinus (only for cranioplasty with acrylates)* and 5. small bone defects (diameter less than 2 cm) which are covered with a layer of thick muscle.

The palacos prosthesis was implanted without complications. During the postoperative course her clinical condition improved rapidly. An impressive regression of the severe ataxia as well as an improvement of her mental state was observed (Figs. 39a, b). Case No3: A 52-year-old patient with an aneurysm of the left a. communicans posterior developed progressive clouding of consciousness a week after the clipping of the aneurysm. A subdural haematoma which appeared postoperatively was removed and a bone flap decompression was undertaken because of brain oedema.

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