The history of military cranioplasty

Christopher M. Bonfield, Anand R. Kumar, Peter C. Gerszten

Research output: Contribution to journalArticle

Abstract

There is evidence that the neurosurgical procedure of cranioplasty is as ancient as its better-known counterpart, trephination. With origins in pre-Incan Peru, cranioplasty remains an important reconstructive procedure for modern craniofacial surgery teams to master. Solutions to the often challenging problem of repairing skull defects continue to evolve to improve patient outcomes. Throughout recorded history, advances in cranioplasty have paralleled major military conflicts due to survivorship after trephination or decompressive craniectomy. Primitive skull coverings used in Peru were later replaced during the Middle Ages by grafts obtained in animals and humans. Improved survivorship secondary to advances in anesthesia and battlefield medicine during the Crimean War and the American Civil War allowed the use of tantalum and acrylic cranioplasty to evolve during World Wars I and II. In the modern era of the Iraq and Afghanistan conflicts, greater survivorship after cranial injury due to improvements in protective armor, medical evacuation, and early "far-forward" neurosurgical treatment have occurred. Consequently, the last decade has seen great advancement in cranial defect reconstruction, including custom-fabricated alloplast implants and the emergence of regenerative cranial treatments such as distraction osteogenesis, protected bone regeneration, and free tissue transfers. Comprehensive rehabilitation after neurotrauma has emerged as the new standard of care.

Original languageEnglish (US)
Article numberE18
JournalNeurosurgical Focus
Volume36
Issue number4
DOIs
StatePublished - 2014

Fingerprint

Trephining
Peru
Survival Rate
History
Skull
Crimean War
American Civil War
Decompressive Craniectomy
World War I
Tantalum
Neurosurgical Procedures
Distraction Osteogenesis
Afghanistan
Iraq
World War II
Bone Regeneration
Standard of Care
Rehabilitation
Anesthesia
Medicine

Keywords

  • Cranial defect
  • Cranioplasty
  • Decompressive craniectomy
  • Warfare-related trauma

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology
  • Medicine(all)

Cite this

Bonfield, C. M., Kumar, A. R., & Gerszten, P. C. (2014). The history of military cranioplasty. Neurosurgical Focus, 36(4), [E18]. https://doi.org/10.3171/2014.1.FOCUS13504

The history of military cranioplasty. / Bonfield, Christopher M.; Kumar, Anand R.; Gerszten, Peter C.

In: Neurosurgical Focus, Vol. 36, No. 4, E18, 2014.

Research output: Contribution to journalArticle

Bonfield, CM, Kumar, AR & Gerszten, PC 2014, 'The history of military cranioplasty', Neurosurgical Focus, vol. 36, no. 4, E18. https://doi.org/10.3171/2014.1.FOCUS13504
Bonfield, Christopher M. ; Kumar, Anand R. ; Gerszten, Peter C. / The history of military cranioplasty. In: Neurosurgical Focus. 2014 ; Vol. 36, No. 4.
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