title: Optimal timing of autologous cranioplasty after decompressive craniectomy in children.
abstract: OBJECTIVE
  The object of this study was to determine if early cranioplasty after decompressive craniectomy for elevated intracranial pressure in children reduces complications.
  
  
  METHODS
  Sixty-one consecutive cases involving pediatric patients who underwent autologous cranioplasty after decompressive craniectomy for raised intracranial pressure at a single academic children's hospital over 15 years were studied retrospectively.
  
  
  RESULTS
  Sixty-one patients were divided into early (< 6 weeks; 28 patients) and late (≥ 6 weeks; 33 patients) cranioplasty cohorts. The cohorts were similar except for slightly lower age in the early (8.03 years) than the late (10.8 years) cranioplasty cohort (p < 0.05). Bone resorption after cranioplasty was significantly more common in the late (42%) than the early (14%) cranioplasty cohort (p < 0.05; OR 5.4). No other complication differed in incidence between the cohorts.
  
  
  CONCLUSIONS
  After decompressive craniectomy for raised intracranial pressure in children, early (< 6 weeks) cranioplasty reduces the occurrence of reoperation for bone resorption, without altering the incidence of other complications.
authors.affiliation: Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon 97239, USA.
authors.forename: Mark P
authors.initials: MP
authors.lastname: Piedra
authors.forename: Eric M
authors.initials: EM
authors.lastname: Thompson
authors.forename: Nathan R
authors.initials: NR
authors.lastname: Selden
authors.forename: Brian T
authors.initials: BT
authors.lastname: Ragel
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Guillaume
mesh_terms: D000293:Adolescent; D001862:Bone Resorption; D016025:Bone Transplantation; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D056424:Decompressive Craniectomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D019586:Intracranial Hypertension / Q000209:etiology / Q000601:surgery*; D016015:Logistic Models; D008297:Male; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012886:Skull / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D014182:Transplantation, Autologous