title: Acute global ischemic stroke after cranioplasty: case report and review of the literature.
abstract: BACKGROUND
  Cranioplasty procedures are performed usually after devastating neurological injuries requiring craniectomies. Although relatively safe, global intracerebral infarction is a poorly understood, and most often, lethal complication after cranioplasty. We report here one such case with a thorough literature review with insight as to possible etiologies of this injury.
  
  
  METHODS
  A 14-year-old girl underwent a left-sided decompressive hemicraniectomy for treatment of a subdural hematoma and cerebral edema. The patient's neurological condition eventually improved and she presented for cranioplasty repair of the defect 83 days after her initial operation. Six hours after an uneventful procedure, the patient's neurological examination declined. Immediate CT scan revealed global edema. Despite all treatment measures, the patient progressed to global ischemia and brain death and expired.
  
  
  CONCLUSIONS
  Although global intracerebral infarction after cranioplasty is extremely rare, the concepts of vessel injury, venous stasis, and reperfusion into dysfunctional cerebral tissue after cranioplasty should be considered when evaluating the risk of this procedure.
authors.affiliation: Department of Neurosurgery, Rush University Medical Center, Chicago, IL.
authors.forename: Erwin
authors.initials: E
authors.lastname: Mangubat
authors.forename: Sepehr
authors.initials: S
authors.lastname: Sani
mesh_terms: D000293:Adolescent; D001929:Brain Edema / Q000150:complications / Q000601:surgery; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D056424:Decompressive Craniectomy / Q000009:adverse effects*; D005260:Female; D015600:Glasgow Coma Scale; D006408:Hematoma, Subdural / Q000150:complications / Q000601:surgery; D006801:Humans; D011183:Postoperative Complications; D020521:Stroke / Q000209:etiology*; D015898:Tomography Scanners, X-Ray Computed