A Comparative Study of the Effects of Early Versus Late Cranioplasty on Cognitive Function

Carla B. Rynkowski, Chiara Robba, Ricardo Vigolo de Oliveira, Rodrigo Fabretti, Thais Malickovski Rodrigues, Angelos G. Kolias, Guilherme Finger, Marek Czosnyka, Marino Muxfeldt Bianchin

Research output: Chapter in Book/Report/Conference proceedingChapter


Cranioplasty (CP) after decompressive craniectomy (DC) is associated with neurological improvement. We evaluated neurological recovery in patients who underwent late CP (more than 6 months after DC) in comparison with early CP. This prospective study of 51 patients investigated neurological function using the Addenbrooke’s Cognitive Examination Revised (ACE-R), Mini–Mental State Examination (MMSE), Barthel Index (BI), and Modified Rankin Scale (mRS) prior to and after CP. Most patients with traumatic brain injury (74%) were young (mean age 33.4 ± 12.2 years) and male (33/51; 66%). There were general improvements in the patients’ cognition and functional status, especially in the late-CP group. The ACE-R score increased from the time point before CP to 3 days after CP (51 ± 28.94 versus 53.1 ± 30.39, P = 0.016) and 90 days after CP (51 ± 28.94 versus 58.10 ± 30.43, P = 0.0001). In the late-CP group, increments also occurred from the time point before CP to 90 days after CP in terms of the MMSE score (18.54 ± 1.51 versus 20.34 ± 1.50, P = 0.003), BI score (79.84 ± 4.66 versus 85.62 ± 4.10, P = 0.028), and mRS score (2.07 ± 0.22 versus 1.74 ± 0.20, P = 0.015). CP is able to improve neurological outcomes even more than 6 months after DC.

Original languageEnglish
Title of host publicationActa Neurochirurgica, Supplementum
PublisherSpringer Science and Business Media Deutschland GmbH
Number of pages4
Publication statusPublished - 2021

Publication series

NameActa Neurochirurgica, Supplementum
ISSN (Print)0065-1419
ISSN (Electronic)2197-8395


  • Cerebral hemodynamics
  • Cognition
  • Cranioplasty
  • Functional recovery

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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