Dynamic Decompressive Craniotomy with a Novel Reversibly Expandable Plate

    loading  Checking for direct PDF access through Ovid

Abstract

Objective

To assess the feasibility of a dynamic craniotomy procedure with the use of a novel reversibly expandable cranial bone flap fixation plate. The expandable plate allows outward bone flap migration with an increase in intracranial volume or intracranial pressure (ICP).

Methods

Dynamic craniotomy intracranial hypertension compliance was evaluated in a skull model with progressive increase in intracranial volume and compared with the standard craniotomy with fixed plates.

Results

Dynamic craniotomy provided significant control of ICP with increasing intracranial volume compared with the standard craniotomy. With an incremental increase in intracranial volume from 360 mL to 600 mL, the ICP increased from 2.6 to 91.9 mm Hg with the standard craniotomy, whereas with the dynamic craniotomy the ICP for similar intracranial volume increased from 2.5 to 25 mm Hg (p < 0.00001).

Conclusions

The dynamic craniotomy procedure provides superior control of ICP with an abrupt intracranial volume increase when compared with the standard craniotomy.

Related Topics

    loading  Loading Related Articles