{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T21:12:47Z","timestamp":1778188367613,"version":"3.51.4"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T00:00:00Z","timestamp":1727740800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T00:00:00Z","timestamp":1727740800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T00:00:00Z","timestamp":1726617600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction and importance:<\/jats:title>\n                    <jats:p>Cranioplasty is an elective neurosurgical procedure following decompressive craniectomy, often associated with post-operative complications such as hemorrhage, seizures, infection, hydrocephalus, and bone resorption. While seizures post-cranioplasty is not uncommon, Intractable seizures are rare but a dreadful complication following cranioplasty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary:<\/jats:title>\n                    <jats:p>A 23 and 17-year-old male underwent decompression craniectomy for traumatic brain injury and subsequently underwent titanium mesh and acrylic cranioplasty respectively, During the post-operative period both patients developed intractable seizures. Initially seizures were refractory to multiple anti-epileptic drugs and benzodiazepine induced coma. Intractable seizures were controlled gradually with few anti-epileptic drugs after the removal of cranioplasty. During 2 years' follow-up, there was no new episode of seizures complained by patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>Elective cranioplasty following decompressive craniectomy after traumatic head injury is one of the commonest surgical modality carried out globally as a life saving measure.<\/jats:p>\n                    <jats:p>But post-operative complications following cranioplasty such as wound infection, implant displacement, bone resorption, hydrocephalus, epidural hematoma are the commonest observed complications whereas post-operative seizure is the most dreadful complication needing immediate intervention. Along with it intractable seizure is rarer during post- operative period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Intractable seizures post-cranioplasty, though rare, are serious and often linked to cerebral edema from negative pressure drainage and dysregulation of cerebral blood flow. Removing the cranioplasty can restore blood flow regulation, stabilize brain tissue, and resolve seizures. Care providers should be aware of this rare complication and to be counselled the patient and the family before the surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2024.110324","type":"journal-article","created":{"date-parts":[[2024,9,19]],"date-time":"2024-09-19T16:43:45Z","timestamp":1726764225000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Intractable seizures after cranioplasty, a dreadful post-operative complication managed efficiently from Nepal: A case series"],"prefix":"10.1097","volume":"123","author":[{"given":"Ram Prasad","family":"Subedi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shikher","family":"Shrestha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sagun","family":"Ghimire","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dinuj","family":"Shrestha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sudharsan","family":"Awal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"issue":"3","key":"R1-139-20260507","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1016\/j.neurol.2012.06.016","article-title":"The impact of early cranioplasty on cerebral blood flow and its correlation with neurological and cognitive outcome. Prospective multi-Centre study on 24 patients.","volume":"169","author":"Chibbaro","year":"2013","journal-title":"Rev. Neurol. (Paris)"},{"issue":"6","key":"R2-139-20260507","doi-asserted-by":"crossref","first-page":"e560","DOI":"10.1097\/SCS.0000000000003863","article-title":"Seizure after cranioplasty: incidence and risk factors","volume":"28","author":"Wang,","year":"2017","journal-title":"J. Craniofac. Surg."},{"issue":"1","key":"R3-139-20260507","doi-asserted-by":"crossref","first-page":"1","DOI":"10.23736\/S0390-5616.16.03843-1","article-title":"Cranioplasty in neurosurgery: is there a way to reduce complications?","volume":"64","author":"Acciarri,","year":"2020","journal-title":"J. Neurosurg. Sci."},{"key":"R4-139-20260507","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.seizure.2019.03.014","article-title":"Risk factors for the development of seizures after cranioplasty in patients that sustained traumatic brain injury: a systematic review","volume":"69","author":"Spencer,","year":"2019","journal-title":"Seizure"},{"issue":"3","key":"R5-139-20260507","doi-asserted-by":"crossref","first-page":"936","DOI":"10.3171\/2018.4.JNS172519","article-title":"Postcranioplasty seizures following decompressive craniectomy and seizure prophylaxis: a retrospective analysis at a single institution","volume":"131","author":"Yeap,","year":"2018","journal-title":"J. Neurosurg."},{"issue":"5","key":"R6-139-20260507","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1080\/02688697.2018.1481197","article-title":"The incidence and treatment of seizures after cranioplasty: a systematic review and meta-analysis","volume":"32","author":"Yao,","year":"2018","journal-title":"Br. J. Neurosurg."},{"issue":"1","key":"R7-139-20260507","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1007\/s10143-015-0678-3","article-title":"Factors influencing the outcome (GOS) in reconstructive cranioplasty","volume":"39","author":"Krause-Titz,","year":"2016","journal-title":"Neurosurg. Rev."},{"key":"R8-139-20260507","doi-asserted-by":"crossref","DOI":"10.1097\/JS9.0000000000000940","article-title":"Preferred reporting of case series in surgery (PROCESS) 2023 guidelines","author":"Mathew","year":"2023","journal-title":"Int. J. Surg."},{"key":"R9-139-20260507","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.jocn.2020.12.009","article-title":"Complications following titanium cranioplasty compared with nontitanium implants cranioplasty: a systematic review and meta-analysis","volume":"84","author":"Zhu,","year":"2021","journal-title":"J. Clin. Neurosci."},{"key":"R10-139-20260507","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.ijsu.2017.02.017","article-title":"Use of an antiepileptic drug to control epileptic seizures associated with cranioplasty: a randomized controlled trial","volume":"40","author":"Chen,","year":"2017","journal-title":"Int. J. Surg."},{"key":"R11-139-20260507","doi-asserted-by":"crossref","first-page":"e282","DOI":"10.1016\/j.wneu.2019.01.062","article-title":"A novel protocol to reduce early seizures after cranioplasty: a single-center experience","volume":"125","author":"Chen,","year":"2019","journal-title":"World Neurosurg."},{"key":"R12-139-20260507","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1016\/j.wneu.2017.03.020","article-title":"Prophylactic levetiracetam for seizure control after cranioplasty: a multicenter prospective controlled study","volume":"102","author":"Liang,","year":"2017","journal-title":"World Neurosurg."}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261224011052?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261224011052?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2024.110324","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T21:00:59Z","timestamp":1778187659000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2024.110324"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10]]},"references-count":12,"journal-issue":{"issue":"C","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.1016\/j.ijscr.2024.110324","relation":{},"ISSN":["2210-2612"],"issn-type":[{"value":"2210-2612","type":"print"}],"subject":[],"published":{"date-parts":[[2024,10]]},"assertion":[{"value":"2024-08-13","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-18","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}