Infection of Cranioplasty Seen Twenty Years Later
A 43-year-old male patient was admitted to our hospital with the complaint of purulant discharge from the right temporal inscission site for one year. Right temporal craniectomy had been performed for depressed skull fracture in 1989. Twenty days after craniectomy, cranioplasty had been performed to craniectomized region with allograft material.\nSystemic examination was unremarkable. Laboratory examination revealed normal levels of erythrocyte sedimentation rate (5 mm/h), C-reactive protein (0.2 mg/L) and white blood cells (7.9×109/L). There was no microbial yield in culture of purulant discharge.\nIn cranial computed tomography (CT) scan, allograft cranioplasty material and calcified tissue together was seen as hyperdense area (). In cranial MRI scan, allograft cranioplasty material together with calcified and fibrotic tissue thereunder was seen ().\nDuring the operation; white-yellow coloured tissue layer was seen on the surface of cranioplasty material (). After removal of the cranioplasty material; calcified, fibrotic and white-yellow coloured tissue layer 5 mm in thickness was seen in epidural area (). There was no physical change in cranioplasty material after removal of surrounding tissues ().\nNo microbial yield was detected in culture of cranioplasty material and surrounding tissues. The postoperative course was entirely uneventful.