Case series evidence for improvement of executive functions after late cranioplasty

AbstractObjective: Craniectomy, used to relieve refractory intracranial pressure in traumatic brain injury (TBI), may cause cognitive deficits which could be improved by skull breach repair. This paper studied whether late cranioplasty improves a specific pattern of cognitive functions.Design: A case series of five TBI patients with craniectomy undergoing late cranioplasty (median interval time: 14 months, range: 12–36).Methods: Longitudinal neuropsychological and brain MRI assessments 1 week before cranioplasty and 3 months later.Results: After cranioplasty, mean score of the verbal fluency test improved compared to pre-cranioplasty (p = 0.02). Similarly, significant improvements after cranioplasty were observed in other tests scores exploring executive functions, such as working memory (p = 0.03) and speed of attention (p = 0.04), independently from the size and site of cranioplasty.Conclusions: The cognitive improvement induced by cranioplasty, even when performed after a long interval from craniectomy...