Cranioplasty Indications, Techniques, and Results
This monograph presents a comprehensive review of the clinical experience in surgical repair of cranial defects which the author has gained during a period of over ten years. Particular problems of patients undergoing cranioplasty, such as neurological im
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Cranioplasty Indications, Techniques, and Results
Springer-Verlag Wien New York
Dragoslav Stula, M.D. Associate Professor, Neurosurgical Clinic, Department of Surgery University of Basel, Switzerland
This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically those of translation, reprinting, re-use of illustrations, broadcasting, reproduction by photocopying machine or similar means, and storage in data banks.
© 1984 by Springer-VerIag/Wien Softcover reprint of the hardcover 1st edition 1984 The use of registered names, trademarks, etc. in the publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. Product Liability: The publisher can give no guarantee for information about drug dosage and application thereof contained in this book. In every individual case the respective user must check its accuracy by consulting pharmaceutical literature.
With 73 Figures
Library of Congress Cataloging in Publication Data. Stula, D. (Dragoslav), 1939- . Cranioplasty: indications, techniques, and results. 1. Skull-Surgery. 2. Surgery, Plastic. I. Title. (DNLM: 1. Skull-abnormalities. 2. Skull-surgery. 3. Surgery, Plastic. WE 705S934c). RD529.S85. 1984. 617'.514. 84-10694
ISBN-13:978-3-7091-8764-7 e-ISBN-13:978-3-7091-8762-3 DOl: 10.1007/978-3-7091-8762-3
Foreword This monograph presents a comprehensive review of the clinical experience in surgical repair of cranial defects which the author has gained during a period of over ten years. Particular problems of patients undergoing cranioplasty, such as neurological impairments, EEG changes, variations of intracranial pressure, and sinking skin flap syndrome are described and discussed. The author presents convincing evidence of the importance of cranioplasty in improving the quality of life of patients with large and disfiguring cranial defects. Unfortunately, cranioplasty still ameliorates only to a minimal extent the general condition in patients suffering of major cerebral lesions. I am convinced that this volume will serve the purpose it was designed for : that it will be a most helpful introduction into the problems related to reconstructive surgery. Basel, August 1984
Otmar Gratzl
Contents Introduction .............................................................
1
A. History of Cranioplasty ................................................
3
B. Clinical Aspects of Cranial Bone Defects ................................. I. Origin of Cranial Defects .......................................... 1. Acquired Defects .............................................. 2. Congenital Defects ............................................. 3. Demographic and Other Characteristics of Patients ................. II. Neurological and Psychic Changes Before and After Cranioplasty ....... 1. Classification of Neurological Deficits and of the Skin Flap Types ..... 2. The "Sinking Skin Flap Sy
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