WHAT ARE THE REASONS FOR HAVING A

CRANIOPLASTY ?
WHAT YOU NEED TO TELL THE
DOCTOR BEFORE SURGERY ?
If you haveclotting problems.
Any Health problems.
If you aretaking blood thinning agents.
e.g. Warfarin/aspirin/anti- inflammatory
Drug or other allergies
In theoperating theatreyou aregiven ageneral anaesthetic
and then positioned with thebonedefect uppermost. The
areaof theincision isthen shaved and prepared with anti-
septic. You arecovered in drapesso that only theincision
can beseen. Local anaesthetic isinjected and then theskin
iscut. Thescalp isdissected from theduraand theedgesof
thesurrounding bonearecleaned to allow thegraft to stick.
If theoriginal boneis availableor areplacement hasbeen
madepreoperatively then thisisplaced in thedefect and
secured either with screwsand platesor with special discs
(seepict).
HOW IS IT PERFORMED ?
WHAT IS A CRANIOPLASTY ?
Thisiswherethebonedefect in theskull left behind after a
previousoperation or injury isrepaired. Thiscan bedonein
lotsof different ways. Thescalp islifted and something is
placed into/over theboney defect.
Thesubstancesused are:
Theoriginal boneif it waskept.
Rib Graft
Titanium Mesh
Titanium Plate
Synthetic bonesubstitute
Acrylic(prefabricated)
Acrylic (fabricated at thetimeof surgery)
Cosmetic A holein thehead looksunsightlty
Protection Thedefect if in certain placesleaves
thebrain exposed and may allow damageto occur.
Headaches Sometimesheadachescan occur if the
boneisnot replaced.
Function In somepatientsthereisadefinite
improvement in neurological function if theboneis
replaced
ORIGINAL BONE
TITANIUM PLATE
ACRYLIC SUBSTITUTE
© MNEUROSURGERY
ELBOURNE
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CRANIOPLASTY
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NEURO SURGERY
www.neurosurgery.com.au
M
E L B O U R N E
NEURO SURGERY
© Thisbrochureiscopyright. No part of it may berepro-
duced in any form without prior permission from the
publishers.
Disclaimer Thisbrochureisto providegeneral infor-
mation and does not replace a consultation with your
doctor.
WHAT HAPPENS WHEN YOU GO HOME ?
WHAT ARE THE RISKS?
THE COMMON RISKSARE
Infection (treated with antibiotics)
Post operativeblood clot requiring drainage.
Stroke
Seizure
Death (rare)
Clot in thelegs(can travel to thelungs[uncommon])
Complication not related directly to thesurgery
e.g. Pneumonia
Heart attack
Urineinfection
YOU WILL BE ASKED TO SIGN A CONSENT FORM
TO SAY THAT YOU UNDERSTAND THE RISKS.
IF YOU ARE NOT SURE ASK BEFORE YOU SIGN.
WHAT YOU SHOULD NOTIFY
YOUR DOCTOR OF AFTER SURGERY
Increasing Headache
Fever
Fitting
Swelling or infection in thewound.
Fluid leaking from thewound.
Weaknessor numbness
Drowsiness
You will betired
It iscommon to requirearest in theafternoon
You may haveintermittant headaches.
Thesewill all improvewith time.
DO NOT DRIVE UNTIL YOU ARE REVIEWED
You will bereviewed at 4 - 6 weekspost operatively.
HOW BIG ISTHE CHANCE OF INFECTION ?
Becausethereisan implant therisk of infection isnot
small. Even thebonethat weuseistechnically dead and
may still get infected. It dependson thethesubstancewe
use. Thebiggest risk isprobably if weusetheacrylic graft.
If an infection doesoccur then wetakeout theimplant and
replaceit with something elsewhen theinfection has
cleared. If thecranioplasty isbeing donebecauseyou have
had infection in thepast therisk of infection still remains
high becauseof thechanceof re-activation.
Sometimesthebonethat weusemay bereabsorbed by the
body. Thismay benoticableand need repair later with a
different typeof implant.
neurosurgery.com.au Discusstheseand otherswith your surgeon
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WHAT HAPPENS NEXT ?
If thegraft isnot availableoneisfashioned from thechosen
material. Thisiscontoured to fit. Thisisalso fixed to the
surrounding bone. Onceplated all bleeding isstopped.
Everything isthen repositioned theway wefound it. The
skin isthen closed either with nylon sutureor with special
staples.
You will wakeup in recovery and after about 1 hour you
will betransferred to theward. Thenursing staff will be
continually checking your pulse/blood pressure/limb
strengthsand level of alertness looking for any changesto
indicateacomplication. During thefirst night on theward
you will bewoken for theseobservations. You will have
intramuscular and oral analgesia. Operationson thehead
do not often hurt much.
Sometimesyou will havedifficulty passing water and ayou
may requireacatheter(thismay havebeen inserted for the
operation).
In thenext day or so thedrip in your arm will beremoved.
Usually thisistheday after surgery. Theday after surgey
you will beencouraged to go for awalk. Gradually over the
next two daysyou will beableto get around asnormal.
When you arecomfortableyou will beableto go home. You
may havearepeat scan of your head beforegoing home.
Commonly you will haveaheadachefor awhileafter the
operation. Thesuturesareusually removed about 5 - 10
daysafter thesurgery.
HOW LONG WILL YOU BE IN
HOSPITAL
Unlessyou havebeen admitted asan emergency you may be
admitted on theday of surgery or theday before. You will
fast from midnight on theday of surgery.
You will bedischarged about 5-7 dayspost-operatively.
On dischargeyou will beableto perform most tasksof daily
living (e.g. showering/dressing/etc.) Depending on how
quickly you recover from any preoperativedisability you
may requirerehabilitation.