Abstract
BACKGROUND: A growing cohort of malignant cerebral infarction (MCI) patients after decompressive craniectomy (DC) required cranioplasty (CP). However, few studies have reported the effect of CP on functional improvements in post-DC MCI patients. The aim of this study was to determine whether early CP for post-DC MCI patients enhances surgical outcomes and alters overall complication rate. METHODS: 86 post-DC MCI patients after CP were divided into the early CP cohort and the traditional CP cohort according to the time span from DC to CP. Complications, NIHSS, mBI, mRS, and CRS-r were assessed, and early CP and traditional CP were defined as occurring less than or more than 3 months after DC. RESULTS: Complications were observed in 9 patients (24.32%) in the early CP cohort and 14 patients (28.57%) in the traditional CP cohort (p > 0.05). NIHSS, mRS, mBI, and CRS-r between pre-operation and post-operation did significantly differ (p < 0.05). Between the two cohorts, operative time, intraoperative blood loss, post-operative parameters (NIHSS, mBI and mRS), ∆NIHSS, and ∆mBI did significantly differ (p < 0.05), while post-operative CRS-r did not significantly differ (p > 0.05). There was a linear relationship between ∆NIHSS and the time span from DC to CP (r = 0.505, p < 0.0001), and there was a linear relationship between ∆BI and the time span from DC to CP (r = -0.568, p < 0.0001). CONCLUSIONS: Our study demonstrated that, first, CP has a favorable effect on improving neurological function, ability to perform daily living, and consciousness in post-DC MCI patients; second, early CP does not alter the overall complication rate and is as safe as traditional CP; third, compared to traditional CP, early CP reduces operative time and intraoperative blood loss, promotes improvements in neurological function and ability to perform daily living, and enhances these improvements.