The Effect of Ultra-Late Cranioplasty in a Patient with Long-Term Disorders of Consciousness

Abstract

Background/Objectives: Cranioplasty (CP) is the main surgical procedure aiming to repair a morphological defect in the skull. It has been shown that early CP is useful for patients with traumatic brain injury (TBI) to achieve functional recovery, whereas few studies have investigated the clinical effects of ultra-late CP on TBI outcomes. Methods: Here, we describe the clinical course over 2 years of a TBI patient who underwent CP 19 months after fronto-parietal decompressive craniectomy (DC) of a limited size. Results: We found that after ultra-late CP, a meaningful functional recovery (cognitive and motor), with emergence from a minimally conscious state and recovery of functional communication, was revealed. Conclusions: Our preliminary findings contribute to the actual debate on the timing of CP for this neurosurgical procedure’s therapeutic success, as early CP has already been shown.

Keywords

• ultra-late cranioplasty (CP)
• functional recovery in long term
• traumatic brain injury (TBI)
• vegetative state/unresponsive wakefulness syndrome (VS/UWS)
• minimally conscious state (MCS)
• disorder of consciousness (DoC)