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In Situ Hinge Craniectomy

Overview
Journal Neurosurgery
Specialty Neurosurgery
Date 2007 Apr 7
PMID 17415161
Citations 24
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Abstract

Objective: To describe an optional method for performing decompressive craniectomy using in situ hinge craniectomy technique in patients with traumatic brain injury and stroke.

Methods: Sixteen patients underwent surgery for treatment of presenting pathology followed by the placement of hinge craniectomy. The technique is detailed.

Results: Six patients with traumatic head injury and 10 with stroke underwent treatment of their primary pathologies with subsequent hinge craniectomy. Of these patients, more than half underwent refixation of the hinge in a minor procedure after recovery. No patient had complications related to this technique and none required further cranial decompression. In patients with intracranial pressure monitoring, all displayed values in the normal range.

Conclusion: In this limited study, in situ hinge craniectomy proved useful in the treatment of patients experiencing stroke or traumatic brain injury. This procedure has the potential to eliminate the additional second incision to explant the bone flap or the refrigeration storage of the bone flap. Also, the second operation to restore the cranial contour by reimplanting the bone flap or by the creation of a cranioplasty with artificial material would not be necessary.

Citing Articles

Comparison of Outcomes of Hinge Craniotomy Versus Decompressive Craniectomy in Patients With Malignant Intracranial Hypertension: A Prospective, Randomized Controlled Study.

Harifi M, Ghadirian H, Karimi-Yarandi K, Nouri M, Ahmadiabhari S, Mortazavi A Korean J Neurotrauma. 2025; 20(4):262-275.

PMID: 39803344 PMC: 11711021. DOI: 10.13004/kjnt.2024.20.e37.


Hinge Craniotomy for Posterior Cranial Vault Expansion: Using the Keel to the Surgeon's Advantage.

Coggins W, Mehta S, Tanaka T Cureus. 2024; 16(7):e64110.

PMID: 39119426 PMC: 11306406. DOI: 10.7759/cureus.64110.


Correlation Between Volume and Pressure of Intracranial Space With Craniectomy Surface Area and Brain Herniation: A Phantom-Based Study.

Sengupta S, Aggarwal R, Singh M Neurotrauma Rep. 2024; 5(1):293-303.

PMID: 38560491 PMC: 10979661. DOI: 10.1089/neur.2024.0006.


Managing the "big black brain" in low resource setting: A case report of early outcome after hinge craniotomy.

Siahaan A, Nainggolan B, Susanto M, Indharty R, Tandean S Surg Neurol Int. 2024; 14:427.

PMID: 38213438 PMC: 10783690. DOI: 10.25259/SNI_715_2023.


Hinge craniotomy versus standard decompressive hemicraniectomy: an experimental preclinical comparative study.

Biroli A, Bignotti V, Biroli P, Buffoli B, Rasulo F, Doglietto F Acta Neurochir (Wien). 2023; 165(9):2365-2375.

PMID: 37452903 DOI: 10.1007/s00701-023-05715-2.