title: Complications of delayed cranial repair after decompressive craniectomy in children less than 1 year old.
abstract: BACKGROUND
  Decompressive craniectomy is an effective treatment option in case of refractory intracranial hypertension after severe head injury. The incidence of complications following cranial repair after decompressive craniectomy for traumatic brain injury is not negligible, particularly in infants and young toddlers. However, only a few dedicated papers can be found in the literature.
  
  
  METHODS
  We describe the complications observed in two boys and one girl under 1 year of age that were treated in the last decade by hemicranial decompressive craniotomy and enlarging hemispheric duraplasty, and subsequent cranial repair by means of autologous bone-flap replacement.
  
  
  RESULTS
  Despite good clinical and neurological outcome, the postoperative clinical course was complicated in all cases by early or late evidence of subdural fluid collections associated to the occurrence of hydrocephalus and causing recurrent dislocation and progressive resorption of the autologous bone flap.
  
  
  CONCLUSIONS
  Infants less than 1 year old, undergoing decompressive craniectomy after traumatic brain injury, experience a high rate of complications following subsequent cranial repair. Subdural collections and resorption of the autologous bone flap are to be considered as extremely common complications.
authors.affiliation: Pediatric Neurosurgery, Policlinic A. Gemelli, Catholic Medical School, Rome, Italy. paolo.frassanito@gmail.com
authors.forename: Paolo
authors.initials: P
authors.lastname: Frassanito
authors.forename: Luca
authors.initials: L
authors.lastname: Massimi
authors.forename: Massimo
authors.initials: M
authors.lastname: Caldarelli
authors.forename: Gianpiero
authors.initials: G
authors.lastname: Tamburrini
authors.forename: Concezio
authors.initials: C
authors.lastname: Di Rocco
mesh_terms: D000367:Age Factors; D056424:Decompressive Craniectomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012886:Skull / Q000254:growth & development / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing