Hinge Technique in One Stage Reduction Cranioplasty for Macrocephaly with Hydrocephalus: A Case Report

Abstract

Reduction cranioplasty is one of the treatment modality among many treatment options for macrocephaly with hydrocephalus. The most previous techniques of reduction cranioplasty have some disadvantages such as difficult airway maintenance, pressure sore due to modified prone position, severe venous infarct due to obstruction of venous blood flow and large amount of bleeding from the dissection of superior sagittal sinus to obtain bone fragment needed. A 28-month-old girl had extreme macrocephaly. She couldn't control head rotation and keep sitting position. The operation was performed at supine position with adequate exposure of entire calvarium and the hinge was made in occipital bone fragment that covered posterior part of superior sagittal sinus. Bleeding volume and the other complications were decreased and acceptable reduction was achieved with this method.