Peer-reviewed veterinary case report
Cranioplasty with 3D titanium mesh after brain injury or stroke
By Zheng B et al.·2026·Department of Neurosurgery, China·View original on Europe PMC →
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Original publication title: Effects of cranioplasty with customized 3D titanium mesh plates on postoperative complications and neurological outcomes following traumatic brain injury or stroke: a single-center retrospective study.
Plain-English summary
This study looked at how well a specific type of surgery, called cranioplasty (which involves repairing the skull), works for patients who have had a serious brain injury or stroke. Researchers focused on patients who received a custom-made 3D titanium mesh plate to cover the skull after a previous surgery to relieve pressure on the brain. They found that about 45% of patients had complications after the surgery, and 30% had poor recovery in terms of brain function. The results suggested that having the cranioplasty done within three months of the initial surgery is safer and linked to better outcomes, while waiting longer could lead to more problems. Overall, early cranioplasty seems to be a safe option, but those who had a stroke may not recover as well as those with a traumatic brain injury.
Abstract
<h4>Background and objectives</h4>Persistent controversy surrounds the identification of risk factors contributing to postoperative complications and unfavorable neurological prognoses following cranioplasty (CP) after decompressive craniectomy (DC). This study sought to assess these postoperative outcomes in individuals undergoing 3D titanium mesh CP due to traumatic brain injury (TBI) or hemorrhagic stroke, as well as to determine predictors linked to postoperative complications and suboptimal neurological recovery.<h4>Methods</h4>A retrospective, single-center analysis was performed on patients undergoing 3D titanium mesh CP after DC. The primary outcome measure encompassed postoperative complications occurring within 12 months post-CP. The secondary endpoint involved the Glasgow Outcome Scale score assessed at 12 months following CP. We examined various parameters to identify predictors associated with postoperative complications and unfavorable neurological outcomes.<h4>Results</h4>A total of 118 male patients (66%) were included, with trauma accounting for DC in 123 cases (68%). The overall incidence of postoperative complications was 45%, while poor neurological outcomes were observed in 30% of cases. Intraoperative dural depression during CP was correlated with an increased likelihood of postoperative epidural effusion; a time interval exceeding three months between DC and CP was associated with a heightened risk of hydrocephalus; bilateral CP demonstrated an elevated risk of wound dehiscence and infection. For poor GOS outcomes, pre-DC GCS score and DC due to stroke were identified as contributing factors, though no association was found with surgical timing.<h4>Conclusion</h4>Early 3D titanium mesh CP, performed within three months after DC in TBI or stroke patients, appears to be a safe procedure without an increased incidence of postoperative complications or poor neurological prognosis. Conversely, delayed CP exceeding three months post-DC may increase the hydrocephalus's likelihood. Patients experiencing intraoperative dural depression during CP should be closely monitored for the potential development of postoperative epidural effusion. Additionally, those undergoing bilateral CP are at greater risk for wound dehiscence and infection. Compared to individuals with TBI-induced DC, stroke patients undergoing CP tend to exhibit poorer neurological recovery.
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Search related cases →Original publication on Europe PMC: https://europepmc.org/article/MED/41634443