• Haifeng Wang, Kewei Zhang, Hongshi Cao, Xiaohong Zhang, Ye Li, Qiang Wei, Dezhi Zhang, Qian Jia, and Li Bie.
• *Department of Neurosurgery of the First Clinical Hospital, Jilin University, Changchun, China†Department of Pathology and Laboratory Medicine, University of California, Irvine, CA.
• J Craniofac Surg. 2017 Sep 1; 28 (6): e560-e564.

BackgroundTo investigate clinical characteristics of postcranioplasty seizures (PCS) first observed after cranioplasty after decompressive craniectomy (DC) to treat traumatic brain injury and to define factors that increase PCS risk.MethodsThis retrospective study, covering the period between January 2008 and July 2015, compared PCS in postcranioplasty patients. Postcranioplasty seizures risk factors included diabetes mellitus, hypertension, time between DC and cranioplasty, duraplasty material, cranioplasty contusion location, electrocautery method, PCS type, and infection. Multivariate logistic regression analysis was performed and confidence intervals (CIs) were calculated (95% CI).ResultsOf 270 patients, 32 exhibited initial PCS onset postcranioplasty with 11.9% incidence (32/270). Patients fell into immediate (within 24 hours), early (from 1 to 7 days), and late (after 7 days) PCS groups with frequencies of 12, 5, and 15 patients, respectively. Generalized, partial, and mixed seizure types were observed in 13, 13, and 6 patients, respectively. Multivariate logistic regression analysis showed increased risk with increasing age (>50 years). Cranioplasty contusion location, precranioplasty deficits, duraplasty material, and monopolar electrocautery were predictive of PCS onset (P < 0.05). Increased DC to cranioplasty interval increased risk but was not statistically significant (P = 0.062).ConclusionsUnderstanding risk factors for PCS will benefit the management of cranioplasty patients.

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