Aspects on Decompressive Craniectomy in Patients with Traumatic Head Injuries

World War I advanced the development of aviation from the concept of flight to the use of aircraft on the battlefield. Fighter planes advanced technologically as the war progressed. Fighter pilot aces Francesco Baracca and Manfred von Richthofen (the Red Baron) were two of the most famous pilots of this time period. These courageous fighter aces skillfully maneuvered their SPAD and Albatros planes, respectively, while battling enemies and scoring aerial victories that contributed to the course of the war. The media thrilled the public with their depictions of the heroic feats of fighter pilots such as Baracca and the Red Baron. Despite their aerial prowess, both pilots would eventually be shot down in combat. Although the accounts of their deaths are debated, it is undeniable that both were victims of traumatic head injury.

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The therapeutic effect of cranioplasty in severe head injuries: Report of two cases

Indian Journal of Neurosurgery ◽

10.4103/2277-9167.118124 ◽

2013 ◽

Vol 02 (02) ◽

pp. 189-192 ◽

Cited By ~ 1

Author(s):

Marco Marsella ◽

Leonardo Tigan ◽

Eric Vicaut ◽

Bernard George ◽

Jean-Pierre Guichard ◽

...

Keyword(s):

Functional Status ◽

Decompressive Craniectomy ◽

Head Injuries ◽

Closed Head Injury ◽

Positive Influence ◽

Perfusion Computed Tomography ◽

Aesthetic Appearance ◽

The Subject ◽

Global Brain ◽

State Examination

Abstract Aesthetic appearance and brain protection are the main indications for cranial reconstruction following decompressive craniectomy. Recently, few reports indicated that cranioplasty could also improve both, cognitive and functional status. A group of 20 patients were treated with decompressive craniectomy following closed head injury; among these patients, two of them (who represent the subject of the current investigation) had to undergo subsequent cranioplasty removal due to the development of local infection. All patients were evaluated by Glasgow outcome scale, frontal assessment battery and mini-mental state examination at 1 week before completion of the cranioplasty as well as 6 and 24 weeks following cranioplasty. Perfusion computed tomography scans were also performed (1 week before and 6 weeks after cranioplasty) as well as a trans-cranial Doppler 1 week before, and 6 and 24 weeks after. The two patients being the subject of this study were also clinically and radiologically evaluated after cranioplasty removal. These two patients, who represent (not intentionally) two case control, showed a real clinical and cerebral perfusion improvement following repair of the skull defect followed by obvious clinical worsening after the skull flap had to be removed. Cranioplasty is likely not to have just a positive influence on cosmetic and protective features of the patients but also seem to improve both, cognitive and functional status by favorably influencing local and global brain hemodynamic and perfusion.

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