Decompressive craniectomy is a common practice for patients with intracranial hypertension. Secondary rigid structural reconstruction following craniectomy can release the effects of atmospheric pressure on the brain,...Decompressive craniectomy is a common practice for patients with intracranial hypertension. Secondary rigid structural reconstruction following craniectomy can release the effects of atmospheric pressure on the brain, and the brain can become dilated. Although some cases with complications induced by cranioplasty, such as intracranial hematoma, have been reported, no clinical cases with intracerebral hemorrhage after rigid reconstruction have been reported. This case report describes a 39-year-old man with a skull defect following clipping with simultaneous decompressive craniectomy for a subarachnoid hemorrhage. About 25 months later, cranioplasty using a custom-made hydroxyapatite (HAP) ceramic implant was performed. Immediately after the operation, intracerebral hemorrhage was detected on the opposite side by computed tomography (CT). However, there were no physical or neurological findings, the hematoma was completely absorbed within 3 weeks postoperatively, and the skull retained a good shape. This case suggests that rigid reconstruction of a skull defect can influence intracranial conditions, and early postoperative CT is important to detect complications.展开更多
Fibrous dysplasia is a benign osseous disease, although radical resection is commonly recommended because of the possibility of recurrence or malignant change. However, radical resection is undesirable, particularly i...Fibrous dysplasia is a benign osseous disease, although radical resection is commonly recommended because of the possibility of recurrence or malignant change. However, radical resection is undesirable, particularly in the maxillofacial region, because facial bones are difficult to replace in an aesthetically-pleasing manner after radical excision. In our department, conservative shaving, as reported by Chen and Noordhoff, is used to reduce tumor volume while maintaining facial aesthetics that are as normal as possible. We have experienced eight cases of craniomaxillofacial fibrous dysplasia and successfully applied conservative shaving to the maxillofacial lesions. These cases have exhibited no recurrence, and their facial contours have improved remarkably.展开更多
文摘Decompressive craniectomy is a common practice for patients with intracranial hypertension. Secondary rigid structural reconstruction following craniectomy can release the effects of atmospheric pressure on the brain, and the brain can become dilated. Although some cases with complications induced by cranioplasty, such as intracranial hematoma, have been reported, no clinical cases with intracerebral hemorrhage after rigid reconstruction have been reported. This case report describes a 39-year-old man with a skull defect following clipping with simultaneous decompressive craniectomy for a subarachnoid hemorrhage. About 25 months later, cranioplasty using a custom-made hydroxyapatite (HAP) ceramic implant was performed. Immediately after the operation, intracerebral hemorrhage was detected on the opposite side by computed tomography (CT). However, there were no physical or neurological findings, the hematoma was completely absorbed within 3 weeks postoperatively, and the skull retained a good shape. This case suggests that rigid reconstruction of a skull defect can influence intracranial conditions, and early postoperative CT is important to detect complications.
文摘Fibrous dysplasia is a benign osseous disease, although radical resection is commonly recommended because of the possibility of recurrence or malignant change. However, radical resection is undesirable, particularly in the maxillofacial region, because facial bones are difficult to replace in an aesthetically-pleasing manner after radical excision. In our department, conservative shaving, as reported by Chen and Noordhoff, is used to reduce tumor volume while maintaining facial aesthetics that are as normal as possible. We have experienced eight cases of craniomaxillofacial fibrous dysplasia and successfully applied conservative shaving to the maxillofacial lesions. These cases have exhibited no recurrence, and their facial contours have improved remarkably.
