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Cranioplasty and Scar Revision

Contributors: Michael Golinko (MD) and Kumar Patel (PA)

A six-year-old male with history of skull trauma acquired in an ATV accident underwent emergency craniotomy three years ago. He now presents with bone resorption, frontal bossing, scalloped bone, and a widened scar in the middle of his forehead from the previous surgery.

DOI#:https://doi.org/10.17797/bysho32ez5

Cranioplasty with Scar Revision
- Cranioplasty: After compound fracture of the skull; After decompressive craniotomy/craniectomy for hemorrhages, stroke, edema, or trauma - Scar Revision: To improve the aesthetic appearance of a scar and/or restore function of skin
Infection, Hydrocephalus, Brain Swelling
General anesthesia, mark area of excision for scar and cranial repair, inject with local anesthetic with epinephrine before cleaning site with betadine. Place patient in the supine position.
History and physical, CBC, Coagulation profile, CT, standardized photographs, Anesthesia ASA categorization
parietal bone, temporal bone, sphenoid bone, zygomatic bone, zygomatic process, temporalis muscle
Cranioplasty � improved skull aesthetic and balance, repair bone absorption Scar Revision - aesthetic improvement
Bleeding, infection (osteomyelitis), CSF leak, seizure, transient neurological defect, epidural or subdural hematoma, hydrocephalus
Bleeding, infection (osteomyelitis), CSF leak, seizure, transient neurological defect, epidural or subdural hematoma, hydrocephalus
Michael Golinko, MD Arkansas Children's Hospital University of Arkansas for Medical Sciences College of Medicine
N/A

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