Flail bone flap in decompressive craniotomy for infants: A case series of five patients

Abstract

Background: Subdural hematoma in infants is a challenging condition. Acute subdural hematomas can cause intracranial hypertension and a midline shift, but decompressive craniotomies in young patients have shown promising results with specific complications in this age group. Hinge craniotomy is an old technique used in many neurosurgical procedures associated with elevated intracranial pressure. The objective of this study is to report the usage of flail bone flap in the management of acute subdural hematoma in infants, its outcome, advantages, disadvantages and related complications.

Methods: This is a review of the medical records of 5 infants younger than one-year-old who underwent decompressive craniotomy as management of acute subdural hematoma at Mansoura university hospital.

Results: In this series, five babies were included. Operative time for decompressive craniotomy (DC) ranged from 1 h and 40 min to 3 h. Four infants survived. Three infants recovered with good outcomes and one infant developed hemiparesis.

Conclusion: The use of flail bone flap technique in decompressive craniotomy is associated with a high success rate and low incidence of complications. Large-based studies are still required for a better assessment of the results.