{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T23:50:56Z","timestamp":1782604256455,"version":"3.54.5"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2020,10,3]],"date-time":"2020-10-03T00:00:00Z","timestamp":1601683200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,10,3]],"date-time":"2020-10-03T00:00:00Z","timestamp":1601683200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005788","name":"Medical University of Vienna","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005788","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Acta Neurochir"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Objective<\/jats:title>\n                <jats:p>Cranioplasty (CP) is considered as a straightforward and technically unchallenging operation; however, complication rates are high reaching up to 56%. Presence of a ventriculoperitoneal shunt (VPS) and timing of CP are reported risk factors for complications. Pressure gradients and scarring at the site of the cranial defect seem to be critical in this context. The authors present their experiences and lessons learned.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A consecutive series of all patients who underwent CP at the authors\u2019 institution between 2002 and 2017 were included in this retrospective analysis. Complications were defined as all events that required reoperation. Logistic regression analysis and chi-squared test were conducted to evaluate the complication rates according to suspected risk factors.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 302 patients underwent cranioplasty between 2002 and 2017. The overall complication rate was 17.5%. Complications included epi-\/subdural fluid collection (7.3%) including hemorrhage (4.6%) and hygroma (2.6%), bone graft resorption (5.3%), bone graft infection (2.0%), and hydrocephalus (5.7%). Overall, 57 patients (18.9%) had undergone shunt implantation prior to CP. The incidence of epi-\/subdural fluid collection was 19.3% in patients with VPS and 4.5% in patients without VPS, OR 5.1 (95% CI 2.1\u201312.4). Incidence of hygroma was higher in patients who underwent early CP. Patients with temporary shunt ligation for CP did not suffer from complications.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>CP in patients with a VPS remains a high-risk procedure. Any effort to understand the pressure dynamics and to reduce factors that may trigger the formation of a large epidural space must be undertaken.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00701-020-04597-y","type":"journal-article","created":{"date-parts":[[2020,10,3]],"date-time":"2020-10-03T05:02:41Z","timestamp":1601701361000},"page":"441-446","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Cranioplasty following ventriculoperitoneal shunting: lessons learned"],"prefix":"10.1007","volume":"163","author":[{"given":"Dorian","family":"Hirschmann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beate","family":"Kranawetter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constanze","family":"Kirchschlager","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Tomschik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Wais","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Winter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Millesi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Herta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl","family":"Roessler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Dorfer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,10,3]]},"reference":[{"key":"4597_CR1","doi-asserted-by":"publisher","first-page":"1150","DOI":"10.3171\/2009.7.Jns09505","volume":"112","author":"P De Bonis","year":"2010","unstructured":"De Bonis P, Pompucci A, Mangiola A, D'Alessandris QG, Rigante L, Anile C (2010) Decompressive craniectomy for the treatment of traumatic brain injury: does an age limit exist? J Neurosurg 112:1150\u20131153. https:\/\/doi.org\/10.3171\/2009.7.Jns09505","journal-title":"J Neurosurg"},{"key":"4597_CR2","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1186\/s13054-019-2490-x","volume":"23","author":"T Beez","year":"2019","unstructured":"Beez T, Munoz-Bendix C, Steiger HJ, Beseoglu K (2019) Decompressive craniectomy for acute ischemic stroke. Crit Care 23:209. https:\/\/doi.org\/10.1186\/s13054-019-2490-x","journal-title":"Crit Care"},{"key":"4597_CR3","doi-asserted-by":"publisher","first-page":"508","DOI":"10.1055\/s-0036-1592170","volume":"36","author":"EG Hayman","year":"2016","unstructured":"Hayman EG, Kurland DB, Grunwald Z, Urday S, Sheth KN, Simard JM (2016) Decompressive craniectomy in neurocritical care. Semin Neurol 36:508\u2013519. https:\/\/doi.org\/10.1055\/s-0036-1592170","journal-title":"Semin Neurol"},{"key":"4597_CR4","doi-asserted-by":"publisher","first-page":"1120","DOI":"10.3171\/2009.6.Jns09133","volume":"112","author":"V Chang","year":"2010","unstructured":"Chang V, Hartzfeld P, Langlois M, Mahmood A, Seyfried D (2010) Outcomes of cranial repair after craniectomy. J Neurosurg 112:1120\u20131124. https:\/\/doi.org\/10.3171\/2009.6.Jns09133","journal-title":"J Neurosurg"},{"key":"4597_CR5","doi-asserted-by":"publisher","first-page":"E9","DOI":"10.3171\/2009.3.Focus0962","volume":"26","author":"MR Gooch","year":"2009","unstructured":"Gooch MR, Gin GE, Kenning TJ, German JW (2009) Complications of cranioplasty following decompressive craniectomy: analysis of 62 cases. Neurosurg Focus 26:E9. https:\/\/doi.org\/10.3171\/2009.3.Focus0962","journal-title":"Neurosurg Focus"},{"key":"4597_CR6","doi-asserted-by":"publisher","first-page":"1648","DOI":"10.3171\/2016.11.Jns161917","volume":"128","author":"RP Morton","year":"2018","unstructured":"Morton RP, Abecassis IJ, Hanson JF, Barber JK, Chen M, Kelly CM, Nerva JD, Emerson SN, Ene CI, Levitt MR, Chowdhary MM, Ko AL, Chesnut RM (2018) Timing of cranioplasty: a 10.75-year single-center analysis of 754 patients. J Neurosurg 128:1648\u20131652. https:\/\/doi.org\/10.3171\/2016.11.Jns161917","journal-title":"J Neurosurg"},{"key":"4597_CR7","doi-asserted-by":"publisher","first-page":"182","DOI":"10.3171\/2014.9.Jns14405","volume":"123","author":"M Zanaty","year":"2015","unstructured":"Zanaty M, Chalouhi N, Starke RM, Clark SW, Bovenzi CD, Saigh M, Schwartz E, Kunkel ES, Efthimiadis-Budike AS, Jabbour P, Dalyai R, Rosenwasser RH, Tjoumakaris SI (2015) Complications following cranioplasty: incidence and predictors in 348 cases. J Neurosurg 123:182\u2013188. https:\/\/doi.org\/10.3171\/2014.9.Jns14405","journal-title":"J Neurosurg"},{"key":"4597_CR8","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1016\/j.jocn.2016.04.017","volume":"33","author":"JG Malcolm","year":"2016","unstructured":"Malcolm JG, Rindler RS, Chu JK, Grossberg JA, Pradilla G, Ahmad FU (2016) Complications following cranioplasty and relationship to timing: a systematic review and meta-analysis. J Clin Neurosci 33:39\u201351. https:\/\/doi.org\/10.1016\/j.jocn.2016.04.017","journal-title":"J Clin Neurosci"},{"key":"4597_CR9","doi-asserted-by":"publisher","first-page":"686","DOI":"10.1016\/j.wneu.2017.04.066","volume":"103","author":"CM Mustroph","year":"2017","unstructured":"Mustroph CM, Malcolm JG, Rindler RS, Chu JK, Grossberg JA, Pradilla G, Ahmad FU (2017) Cranioplasty infection and resorption are associated with the presence of a ventriculoperitoneal shunt: a systematic review and meta-analysis. World Neurosurg 103:686\u2013693. https:\/\/doi.org\/10.1016\/j.wneu.2017.04.066","journal-title":"World Neurosurg"},{"key":"4597_CR10","doi-asserted-by":"publisher","first-page":"313","DOI":"10.3171\/2014.2.Jns131480","volume":"121","author":"J Heo","year":"2014","unstructured":"Heo J, Park SQ, Cho SJ, Chang JC, Park HK (2014) Evaluation of simultaneous cranioplasty and ventriculoperitoneal shunt procedures. J Neurosurg 121:313\u2013318. https:\/\/doi.org\/10.3171\/2014.2.Jns131480","journal-title":"J Neurosurg"},{"key":"4597_CR11","doi-asserted-by":"publisher","first-page":"1051","DOI":"10.1016\/j.wneu.2015.05.066","volume":"84","author":"P Schuss","year":"2015","unstructured":"Schuss P, Borger V, G\u00fcresir \u00c1, Vatter H, G\u00fcresir E (2015) Cranioplasty and ventriculoperitoneal shunt placement after decompressive craniectomy: staged surgery is associated with fewer postoperative complications. World Neurosurg 84:1051\u20131054. https:\/\/doi.org\/10.1016\/j.wneu.2015.05.066","journal-title":"World Neurosurg"},{"key":"4597_CR12","doi-asserted-by":"publisher","first-page":"830","DOI":"10.1016\/j.wneu.2017.08.034","volume":"107","author":"RM Meyer","year":"2017","unstructured":"Meyer RM, Morton RP, Abecassis IJ, Barber JK, Emerson SN, Nerva JD, Ko AL, Chowdhary MC, Levitt MR, Chesnut RM (2017) Risk of complications with simultaneous cranioplasty and placement of ventriculoperitoneal shunt. World Neurosurg 107:830\u2013833. https:\/\/doi.org\/10.1016\/j.wneu.2017.08.034","journal-title":"World Neurosurg"},{"key":"4597_CR13","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1016\/j.wneu.2010.08.001","volume":"74","author":"C Dorfer","year":"2010","unstructured":"Dorfer C, Frick A, Knosp E, Gruber A (2010) Decompressive hemicraniectomy after aneurysmal subarachnoid hemorrhage. World Neurosurg 74:465\u2013471. https:\/\/doi.org\/10.1016\/j.wneu.2010.08.001","journal-title":"World Neurosurg"},{"key":"4597_CR14","doi-asserted-by":"publisher","first-page":"2503","DOI":"10.1177\/0300060518755148","volume":"46","author":"F Zheng","year":"2018","unstructured":"Zheng F, Xu H, von Spreckelsen N, Stavrinou P, Timmer M, Goldbrunner R, Cao F, Ran Q, Li G, Fan R, Zhang Q, Chen W, Yao S, Krischek B (2018) Early or late cranioplasty following decompressive craniotomy for traumatic brain injury: a systematic review and meta-analysis. J Int Med Res 46:2503\u20132512. https:\/\/doi.org\/10.1177\/0300060518755148","journal-title":"J Int Med Res"},{"key":"4597_CR15","doi-asserted-by":"publisher","first-page":"1090","DOI":"10.1089\/neu.2011.2176","volume":"29","author":"P Schuss","year":"2012","unstructured":"Schuss P, Vatter H, Marquardt G, Im\u00f6hl L, Ulrich CT, Seifert V, G\u00fcresir E (2012) Cranioplasty after decompressive craniectomy: the effect of timing on postoperative complications. J Neurotrauma 29:1090\u20131095. https:\/\/doi.org\/10.1089\/neu.2011.2176","journal-title":"J Neurotrauma"}],"container-title":["Acta Neurochirurgica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00701-020-04597-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00701-020-04597-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00701-020-04597-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,4]],"date-time":"2021-10-04T20:57:04Z","timestamp":1633381024000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00701-020-04597-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,3]]},"references-count":15,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,2]]}},"alternative-id":["4597"],"URL":"https:\/\/doi.org\/10.1007\/s00701-020-04597-y","relation":{},"ISSN":["0001-6268","0942-0940"],"issn-type":[{"value":"0001-6268","type":"print"},{"value":"0942-0940","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,3]]},"assertion":[{"value":"6 July 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 September 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 October 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All procedures performed in studies involving human participants were in accordance with the ethical standards of the Medical University of Vienna and the Ethics Committee of the Medical University of Vienna and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"For this type of study formal consent is not required.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Formal consent"}}]}}