title: Hydroxyapatite cement resistant to fragmentation following full cerebrospinal fluid bathing.
abstract: Prolonged cerebrospinal fluid bathing of cranioplasty cement frequently results in breakdown of the cement implants. A 5-year-old boy with a history of severe head trauma at 2 weeks of age presented with marked protrusion of the entire superior temporal bone and inferior parietal bone. The defect was elevated by more than 1 cm and was associated with a 4.5 x 3-cm skull defect located above and behind the right ear. There also was pulsatile tissue at the depths of the defect. A computed tomographic scan taken of the head revealed an expanding skull fracture from a dural defect with underlying brain herniation. The cranial lesion was repaired with OsteoVation hydroxyapatite cement. Within 8 weeks, the fluid encased the cranioplasty site. This resolved following implantation of a shunting device. At 2 and 12 months after the repair, the implant was still palpably solid without breakdown and did not fragment despite the prolonged bathing in cerebrospinal fluid.
authors.affiliation: Neuroscience Institute, Children's Hospital of Orange County, Orange, CA 92868, USA. mmuhonen@aol.com
authors.forename: Michael G
authors.initials: MG
authors.lastname: Muhonen
authors.forename: Anna
authors.initials: A
authors.lastname: Lonyai
authors.forename: Franklin D
authors.initials: FD
authors.lastname: Westhout
mesh_terms: D001672:Biocompatible Materials / Q000737:chemistry / Q000627:therapeutic use*; D001843:Bone Cements / Q000737:chemistry / Q000627:therapeutic use*; D002675:Child, Preschool; D004388:Dura Mater / Q000293:injuries; D017886:Durapatite / Q000134:cerebrospinal fluid / Q000737:chemistry / Q000627:therapeutic use*; D004677:Encephalocele / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D006849:Hydrocephalus / Q000134:cerebrospinal fluid / Q000601:surgery; D008297:Male; D010294:Parietal Bone / Q000293:injuries* / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D012887:Skull Fractures / Q000601:surgery*; D013499:Surface Properties; D013701:Temporal Bone / Q000293:injuries* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D017287:Ventriculoperitoneal Shunt
chemical_list: D001672:Biocompatible Materials; D001843:Bone Cements; D017886:Durapatite