Cranioplasty prognosis [Neurosurgery Wiki]

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====== Cranioplasty prognosis ======

[[Cranioplasty]] [[prognosis]] can be assessed across several [[domain]]s reflecting both clinical [[effectiveness]] and patient-centered results. The [[procedure]], performed after [[decompressive craniectomy]] or to repair [[skull defect]]s, has neurological, functional, cosmetic, and complication-related implications.

==== 🧠 Domain 1: Neurological Recovery ====
  * Improvement in cognitive function, consciousness, and motor performance.
  * Restoration of cerebral perfusion, metabolism, and CSF dynamics.
  * Common assessment tools: NIHSS, neuropsychological testing.

==== 🧩 Domain 2: Functional Outcome ====
  * Tools:
    * Glasgow Outcome Scale (GOS)
    * Modified Rankin Scale (mRS)
    * Functional Independence Measure (FIM)
  * Reflects autonomy, activities of daily living, and care needs.

==== 👤 Domain 3: Cosmetic and Psychological Satisfaction ====
  * Restoration of body image, self-esteem, and social reintegration.
  * Particularly relevant in younger patients.
  * Evaluated via PROMs and patient interviews.

==== ⚠️ Domain 4: Complications ====
  * Infection (5–20%): more common with alloplastic materials or early cranioplasty.
  * Bone flap resorption: especially in pediatric and autologous bone cases.
  * Other risks: seizures, hematomas, hydrocephalus, implant migration.

==== ❤️ Domain 5: Health-Related Quality of Life (HRQoL) ====
  * Includes mobility, communication, cognition, emotional well-being.
  * Tools: EQ-5D, SF-36, disease-specific QoL instruments.