Complications Of Cranioplasty And Analysis Of Risk Factors

Background:Titanium cranioplasty (TC) is well established and considered to be the material in craniectomy defects because it isconvenient, biologically inert, strong, and can shorten operation time, avoid to damage the brain. However, TC is associated with a significant risk of complications.Method:A retrospective review was performed on287patients who underwent TC at The First Affiliated Hospital of Zhejiang University during the period of2010.01-2014.12. Data were collected on demographic characteristics, smoking history, hypertension, diabetes mellitus (DM), indication for primary surgery, skull defect area, interval between craniectomy and TC, post-operative complications and need for further surgery.Results:The overall complication rate was10.45%, the commonest complication was scalp infection or intracranial infection, which accounted for3.83%, followed by secondary epilepsy (2.79%) and hydrocephalus (2.04%). The average age of patients with post-operative complications was48.10±10.90years, and the patient without complications was43.65±13.57, and it was statistically significant (p=0.046). Skull defect area of patients with post-operative complications was114.93±40.43cm2, and the patient without complications was92.94±42.08cm2, it was statistically significant (p=0.007). The average interval between craniectomy and TC was4.42±3.30months,7.23±8.35months for complication group, and4.09±1.79months for non-complication group, and it was statistically significant (p<0.001). The majority of indication of craniectomy was traumatic brain injury (81.18%), and the complication rate was11.16%,9.09%for hypertensive intracerebral hemorrhage,5.88%for intracranial aneurysma,11.11%for brain tumor, and it was not statistically significant (p>0.05).Conclusions:in the research, the overall complication rate was10.45%, concluding secondary epilepsy, hydrocephalus, infection, intracranial hematoma and death. The commonest complication was infection, accounted for3.83%. The risk factors of post-operative complication were increasing age, increasing area of defect, long interval.