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CC BY-NC-ND 4.0 · Indian Journal of Neurosurgery 2021; 10(03): 263-265
DOI: 10.1055/s-0039-1697730
Letter to the Editor

Single-Step Ladder Expansive Cranioplasty: 2-Year Follow-up

Sudip Kumar Sengupta
1   Department of Neurosurgery, Command Hospital (Eastern Command), Kolkata, West Bengal, India
,
Harish Bajaj
1   Department of Neurosurgery, Command Hospital (Eastern Command), Kolkata, West Bengal, India
,
Vinay Maurya
1   Department of Neurosurgery, Command Hospital (Eastern Command), Kolkata, West Bengal, India
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Decompressive hemicraniectomy is often resorted to in cases of severe head injury to deal with, and sometimes in anticipation of, a refractory raised intracranial pressure (ICP). With progressively reducing acceptable time interval between the primary surgery and cranioplasty, concerns regarding trephination syndrome and injury to the unprotected brain have substantially reduced. However, there still remains the necessity of bone flap preservation and a second surgery with its monetary and logistic implications that some patients can ill afford. With a view to devise a surgical technique that can accomplish the aim of achieving adequate intracranial volume expansion required to mitigate the raised ICP without having to subject the patient to a second surgery at a later date, “step ladder expansive cranioplasty” was conceptualized[1] and performed on a patient with acute subdural hematoma (SDH) and was published in Indian Journal of Neurosurgery as a technical note after 3 months of uneventful follow-up.[2] We have subsequently followed up the patient for 2 years.



Publication History

Article published online:
25 March 2021

© 2021. Neurological Surgeons’ Society of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Sengupta SK. Step-ladder expansive cranioplasty after decompressive craniotomy and expansive duraplasty: discussing possibilities on a mathematical model. Indian. J Neurosurg 2015; 4 (01) 15-21
    PubMedGoogle Scholar
  • 2 Sengupta SK. Single-step step ladder expansive cranioplasty. Indian. J Neurosurg. 2017; 6 (02) 107-112
    PubMedGoogle Scholar
  • 3 Münch E, Horn P, Schürer L, Piepgras A, Paul T, Schmiedek P. Management of severe traumatic brain injury by decompressive craniectomy. Neurosurgery 2000; 47 (02) 315-322 discussion 322–323
    CrossrefPubMedGoogle Scholar
  • 4 Cavuşoğlu H, Kaya RA, Türkmenoğlu ON, Aydin Y. Value of early unilateral decompressive craniectomy in patients with severe traumatic brain injury. Ulus Travma Acil Cerrahi Derg 2010; 16 (02) 119-124
    PubMedGoogle Scholar
  • 5 Olivecrona M, Rodling-Wahlström M, Naredi S, Koskinen LO. Effective ICP reduction by decompressive craniectomy in patients with severe traumatic brain injury treated by an ICP-targeted therapy. J Neurotrauma 2007; 24 (06) 927-935
    CrossrefPubMedGoogle Scholar