Original ArticlesCranioplasty An Institutional ExperienceAlves Junior, Aderaldo Costa MD*; Hamamoto Filho, Pedro Tadao MD, MSc†; Gonçalves, Marcelo Pacheco MD*; Palhares Neto, Aristides Augusto MD, PhD‡; Zanini, Marco Antonio MD, PhD*,§Author Information *Faculdade de Medicina de Botucatu, Universidade Estadual Paulista †Hospital das Clínicas da Faculdade de Medicina de Botucatu ‡Departamento de Cirurgia e Ortopedia da FMB-UNESP §Departamento de Neurologia, Psicologia e Psiquiatria da FMB-UNESP, Botucatu, Brazil. Address correspondence and reprint requests to Aderaldo Costa Alves Junior, MD, Departamento de Neurologia, Psicologia e Psiquiatria, Distrito de Rubião Jr, S/N, Botucatu, SP, Brazil. CEP: 18618-970; E-mail: firstname.lastname@example.org Received 24 September, 2017 Accepted 7 February, 2018 The authors report no conflicts of interest. Journal of Craniofacial Surgery: September 2018 - Volume 29 - Issue 6 - p 1402-1405 doi: 10.1097/SCS.0000000000004512 Buy Metrics Abstract Cranioplasty is a common procedure in neurosurgical practice, but associated with high complication rates. In the current study, the authors describe surgical characteristics and results of cranioplasty performed in a tertiary teaching hospital in Brazil. Data were obtained from electronic medical records of cranioplasties performed between January 2013 and November 2016. The sample comprised of 33 patients, and the mean follow-up time was 16 months. Patients presented most of the times a good preoperative status, with 84.8% of patients classified between 0 and 3 at modified Rankin scale and 78.7% with 4 or 5 points at Glasgow Outcome Scale. The most common initial diagnosis was vascular disease (48% of patients) followed by traumatic brain injury (36% of patients). The majority of cranioplasties used an autograft: the autologous bone flap removed during a previous surgery (craniectomy) and stored in the abdominal subcutaneous fat (67% of patients). In 3 patients, the polymethylmethacrylate prosthesis was custom-made prior to the operation using 3-dimensional printing, based on computed tomography images. Five patients (15% of patients) developed symptoms related to surgical site infection, manifesting at an average of 5 weeks following the procedure. Three of them presented scalp dehiscence before the infection symptoms. Cranioplasty should be performed early, as long as clinical conditions are good and the patient has overcome the acute phase of neurological injury. © 2018 by Mutaz B. Habal, MD.