Author(s)

Takayuki Okumoto¹, Tomito Oji^2*, Kazuo Kishi³

¹Department of Plastic and Reconstructive Surgery, Fujita Health University School of Medicine, Aichi, Japan.
²Department of Plastic and Reconstructive Surgery, Sakura Medical Center, Toho University School of Medicine, Chiba, Japan.
³Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan.

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.

Cranioplasty, Rigid Reconstruction, Skull Defect, Intracerebral Hemorrhage, Decompressive Craniectomy

Okumoto, T. , Oji, T. and Kishi, K. (2015) Cranioplasty after Decompressive Craniectomy Caused an Intracerebral Hemorrhage: A Case Report. Modern Plastic Surgery, 5, 28-33. doi: 10.4236/mps.2015.53006.