Immediate Cranioplasty for Postcranioplasty Infection in Patients with Ventriculoperitoneal Shunt

World Neurosurgery
Nobutaka Yoshioka

Abstract

Patients with a ventriculoperitoneal (VP) shunt tend to develop epidural fluid accumulation after cranioplasty and also have a higher frequency of syndrome of the trephined after bone flap removal. Thus treatment of patients with postcranioplasty infection and a VP shunt is often challenging. We treated 2 patients with postcranioplasty infection and a VP shunt. One patient had undergone decompressive craniectomy for cerebral hemorrhage, and the other patient had a large frontal dead space following resection of a brain tumor. Both patients were treated by immediate cranioplasty with obliteration of the epidural dead space by using a vascularized free latissimus dorsi muscle flap. In both of them, the postoperative course was uneventful without any complications. Immediate cranioplasty and obliteration of the epidural dead space with a vascularized free latissimus dorsi muscle flap is an alternative for patients with postcranioplasty infection who are unfavorable candidates for temporary bone flap removal because of the risk of neurologic deterioration.

Citations

Sep 25, 2020·The Journal of Craniofacial Surgery·Christopher M StewartPeter W Thompson
Jan 9, 2021·Rehabilitación·I Martínez-ViñuelaM Díaz-Jiménez

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