Because in daily life, it is inevitable that there will be some bumps, and the brain tissue is very fragile. Without the protection of skull, it is easy to cause intracranial hemorrhage again, and even blood vessels rupture again. Therefore, in this case, it is best to carry out repair treatment, and also to maintain a relatively balanced intracranial pressure.
It is not impossible for some patients not to repair their skulls in clinic, but it may have a series of effects on their lives in the later stage. Therefore, we must make a comprehensive decision according to the specific condition at that time, as well as the family's economic factors and the patient's own wishes.
The reason for taking the skull is that many patients have not installed the skull at that time after craniotomy, which is called decompressive craniectomy. This treatment is often due to serious illness, especially for patients with trauma and cerebrovascular diseases. If you look at the CT changes of the head before operation, the bleeding is very severe and the pressure in the brain is very high, then you may decide to go to the bone flap decompression operation during the operation, and further confirmation is needed during the operation.
If the intracranial pressure is high after craniotomy, it may be that the bone flap cannot be put back or the scalp cannot be sutured. In this case, it is necessary to cut off some brain tissues and take away the bones to give the brain enough time to expand. This is the most important reason to remove the skull, which can give the brain enough time and space to swell after the operation. Then there is the nature of the tumor, especially for tumors invading the skull. At this time, some tumor cells in the skull need to be removed, and the skull defect can be repaired later.
Skull healing without repair is not true bone healing. After craniotomy, the healing of skull is not true bone healing, but fibrous connective tissue healing. If the patient is undergoing general craniotomy, including craniotomy hematoma removal and craniotomy tumor resection, then the skull bone flap cut during the operation needs to return to its original position. This skull bone flap can still be combined with human body.
But its fusion mode is different from that of human long bones. Because human long bone fracture is callus healing. Osteogenesis of long bones is epiphyseal osteogenesis itself. But the osteogenesis of skull is not epiphyseal osteogenesis, but membranous osteogenesis. Therefore, the healing mode of skull bone flap is fibrous connective tissue healing, not callus healing and bone healing.