Decision making in cranioplasty: A case report

Introduction: Decompressive craniectomy (DC) is the treatment for intractable high intracranial pressure (ICP). Patients are left with a skull defect after the surgery which necessitates the need to close the defect. Case presentation: We report a classic traumatic case that required DC and was followed by cranioplasty later. We explained in detail surgical steps which are considered paramount in avoiding complications. We also reviewed the relevant literature which aids surgeons in ideal decision making. Despite all the recent advances, there is no clear guideline on the ideal cranioplasty after DC. Cranioplasty is indicated to recreate the solid skull covering for protection from external injury. Cranioplasty has been proven beneficial in sunken flap syndromes that fail to respond to non-surgical treatment. Conclusion: Cranioplasty is a common procedure but involves many complications if not properly planned or done. Deliberate care must be taken during the perioperative period to prevent complications to ensure a good postoperative outcome.