Cranioplasty split calvaria in pediatric patient

ABSTRACT Background: Cranioplasty in pediatrics often results in a poor outcome. Therefore, proper consideration and decision-making are needed in choosing surgical techniques for cranioplasty in children, especially autologous, which can cause abnormal skull and brain growth. Case description: A 3-year-old girl presented to our outpatient clinic with a complaint of a left front-temporo-parietal skull defect due to a history of acute subdural hemorrhage evacuation and decompressive craniectomy. After a series of failed cranioplasties, the patient then underwent a split calvarial cranioplasty. Postoperatively, the patient was fully conscious and had no neurological deficit. Discussion: Commonly used autologous material with bone graft is those of split rib and split calvarial. Large defect area does not allow the use of split rib. Therefore, split calvaria is the main choice in this case, due to its capability of giving larger defect area obtained, more suitable contour for the defect area, single incision, and more rigidity for cosmetic purpose. Conclusion: Autologous cranioplasty with split calvaria can be used in certain cases of infection or trauma that often causes bone tissue damage, so that autograft bone flap cannot be reused. In pediatric cases, the split calvaria technique is appropriate for children patient that has a problem of skull defect. Highlights