D Cranioplasty
Cranioplasty can be performed for a bony tumor resulting from traumatic injury (e.g., depressed skull fracture) or, more rarely, from a condition resulting from a congenital malformation (e.g., fused suture lines). These defects may occur anywhere on the head, so the surgical procedure may take place with the patient in varying positions such as supine, sitting, prone, or supine with the head turned. Patients range widely in age from newborn to elderly.
Complete blood count (CBC), electrolytes, blood urea nitrogen, creatinine, glucose, prothrombin time, and partial thromboplastin time (D-dimer or fibrin split products if disseminated intravascular coagulation needs to be ruled out) are used. Type and crossmatch (for at least 2 units). Arterial blood gases are measured if the patient is being ventilated.
4. Room preparation
a) Monitoring equipment: Standard. An arterial line and central line are used if suggested by the patient’s history. Foley catheter is indicated if surgery is scheduled for more than 2 hours. Some patients may have an ICP monitor in place, and ICP monitoring should be continued intraoperatively.
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