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Delayed tentorial herniation after crainoplasty with polymethylmethacrylate: a rare complication.
- Source :
-
Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery [J Craniomaxillofac Surg] 2011 Dec; Vol. 39 (8), pp. 624-7. Date of Electronic Publication: 2011 Jan 05. - Publication Year :
- 2011
-
Abstract
- We report the case of a 49-year-old man who underwent a craniectomy for severe head trauma and subsequent cranioplasty with polymethylmethacrylate. He was discharged with moderate right-hand weakness. Five years after the cranioplasty he experienced double vision and slight right hemiparesis. Magnetic resonance imaging (MRI) revealed signs of tentorial herniation but no specific space-occupying lesions. The hand-moulded polymethylmethacrylate bone flap was found to be uneven and protrusions on the inner surface of the bone graft slightly compressed the brain below. His symptoms improved dramatically after a second cranioplasty using a ceramic implant. Although some complications including infection and cosmetic problems have been reported, tentorial herniation during late follow-up as a specific complication of cranioplasty has not been documented previously. We attribute his neurological improvement to the release of compression from the initial graft and to the consequent restoration of cerebrospinal fluid dynamics.<br /> (Copyright © 2010 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)
- Subjects :
- Biocompatible Materials
Ceramics
Decompression, Surgical
Diplopia etiology
Follow-Up Studies
Frontal Bone injuries
Frontal Bone surgery
Headache etiology
Hematoma, Subdural surgery
Humans
Male
Middle Aged
Postoperative Complications
Reoperation
Skull Fractures surgery
Tomography, X-Ray Computed
Bone Substitutes adverse effects
Cerebellar Diseases etiology
Craniotomy adverse effects
Encephalocele etiology
Polymethyl Methacrylate adverse effects
Plastic Surgery Procedures adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1878-4119
- Volume :
- 39
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 21211986
- Full Text :
- https://doi.org/10.1016/j.jcms.2010.11.014