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J Neurol Surg A Cent Eur Neurosurg 2017; 78(04): 386-389
DOI: 10.1055/s-0036-1594013
Technical Note
Georg Thieme Verlag KG Stuttgart · New York

Dynamic Decompressive Craniotomy with a Novel Reversibly Expandable Plate

Rohit Khanna
1   Department of Neurosurgery, Halifax Health, Daytona Beach, Florida, United States
2   Department of Neurosurgery, Florida State University College of Medicine, Daytona Beach, Florida, United States
› Author Affiliations
Further Information

Publication History

19 February 2015

02 May 2016

Publication Date:
30 November 2016 (online)

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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.

Keywords

brain swelling - cerebral edema - cranial fixation - plate - craniectomy - cranioplasty - decompressive craniotomy - intracranial hypertension - malignant stroke - traumatic brain injury
 

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