475 Complications Associated With Early Cranioplasty for Traumatic Brain Injury Patients: A 25-year Single-center Analysis

Abstract

INTRODUCTION: Cranioplasty is a technically simple procedure, but one with potentially high rates of complications. Ideal timing of cranioplasty should minimize the risk of complications, but research investigating cranioplasty timing and risk of complications has generated diverse findings. METHODS: We conducted a single institution retrospective review of patients undergoing cranioplasty after trauma. Patients were identified and clinical and demographic variables obtained from 2 neurotrauma databases. Patients were categorized into 3 groups based on timing of cranioplasty: early (= 90 days after craniectomy), intermediate (91-180 days after craniectomy) and late (>180 days after craniectomy). We also conducted a subgroup analysis in TBI patients who underwent ultra-early cranioplasty (<6 weeks, after craniectomy). RESULTS: Of 435 patients identified, 141 patients underwent early cranioplasty, 187 patients received intermediate cranioplasty, and 107 patients underwent late cranioplasty. A total of 54 patients underwent ultra-early cranioplasty. Among the total cohort, the mean rate of post-op hydrocephalus was 2.8%, the rate of seizure was 4.6%, the rate of post-operative hematoma was 3.4%, and the rate of infection was 6.0%. The total complication rate for the entire population was 16.8%. There was no significant difference in complications between any of the 3 groups. No significant differences in post-operative complications were found comparing the ultra-early cranioplasty group with all other patients combined. CONCLUSION: In this cohort of TB patients, early cranioplasty, including ultra-early procedures, were not associated with higher rates of complications.