My mum had a Bifrontal decompressive craniectomy due to a severe TBI. She spent a month in a coma, is now GCS of 15 in intensive rehab and can talk, eat foods (albeit confused) and will soon be learning to walk. She’s progressing fast and really well. She had severe damage to the frontal lobes (they mention it was one of the worst cases they’ve ever seen).
To be honest, I’m just really worried about the cranioplasty operation because I’ve read into it and it seems it can carry high complication rates etc. She’ll be getting a titanium plate put in 4 months time. (We are 2 months post injury).
Has anyone here experienced this? Or knows what to expect? Or has any helpful advise?
I also wonder if anyone has has experience with the Bifrontal plate specifically because I can’t find much info online.
Thank you 😊
Written by
cjh97
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In the operating room, you are given a general anesthetic. Once you are asleep, the team positions you so the surgeons have optimal access to the bone defect. The area of the incision is then shaved and prepared with antiseptic, and you are protected by drapes that leave only the surgical area exposed.
You will get a local anesthetic, then the surgeon will carefully cut the skin of your scalp and gently separate it into layers, thereby protecting the dura, which covers the brain. The team cleans the edges of surrounding bone and prepares the surface so the bone or implant can be positioned properly in the defect, after which it is secured to the cranial bones with screws, plates or both.
With the bone or implant in place, bleeding is controlled, the team moves the scalp back to its original position and closes the incision with nylon suture. You may also have a small suction drain left in place to help remove any excess fluid. The drain will be removed in a few days.
What is it like to recover from a cranioplasty ?
You will wake up in recovery, and after about an hour you will be transferred to the neurosurgical floor or to the NCCU (neurosurgical intensive care unit). Your nursing staff will continually monitor you for any signs of a complication, and measure your pulse, blood pressure, limb strength and level of alertness. During the first night in the hospital, you will be awakened for these observations.
Operations on the head do not often hurt much, but you may have a headache and will have pain relief pills and injections to ensure you’re comfortable. You may still have a urinary catheter in place from the operation.
In the next day or so, your nurse will remove the IV drip in your arm, and you will be encouraged to walk. Gradually, you will be able to move about normally. Your head bandage will be removed on the second day after surgery.
Most cranioplasty patients spend two to three days in the hospital after surgery. When your care team determines you can get around, shower and dress yourself, you will get a repeat CT scan of your head. If the surgical site looks okay, you will be released and can go home.
What happens when I leave the hospital ?
It may take some time before you feel completely back to normal.
You will be tired.
It is common to require a rest in the afternoon.
You may have intermittent headaches.
You will schedule appointments for one week and three to four weeks after surgery to have your sutures removed.
Depending on how quickly you recover from any preoperative disability, you may require rehabilitation.
I believe many surgeons opt for the titanium plate rather than bone flap for reason of lower infection rates. Hope this helps a little, and all best wishes for the best possible outcome. Cat x
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