When Your Child Needs a Strip Craniectomy

A strip craniectomy is a type of surgery done on the skull. It treats craniosynostosis. This condition is when one or more bones in a child’s skull grow together, or fuse, too early.

Normally, the bones in a child’s skull gradually close over time. This allows the brain to grow. When a child has craniosynostosis, brain growth may be restricted because the skull can't expand. The shape of the head may also become distorted. This can lead to developmental problems and increased pressure in the brain.

Why is a strip craniectomy done?

A strip craniectomy is done to open the fused bone or bones in a child’s skull. It makes space for brain growth and eases pressure in the brain. It can also help fix problems in head shape. After the surgery, a child may wear a custom helmet for several months to help reshape the skull.

What happens before a strip craniectomy?

Before surgery, your child’s healthcare provider will check the shape of your child’s head. They may take photos. They will also ask you questions about your child’s growth and development.

Your child will need some tests. Imaging tests such as a CT scan can help your child’s healthcare provider plan the surgery.

What happens during a strip craniectomy?

A strip craniectomy is done in a hospital. It may be done with one large incision in the skull. Or it may be done through several small cuts using an endoscope. An endoscope is a tool with a light and camera on the end. It helps the surgeon see inside the skull.

During a strip craniectomy:

• Your child lies face down on the operating table. A healthcare provider may place a headrest underneath your child to better align their body and head for the surgery.

• Your child is given medicine to make them fall asleep. They won’t feel any pain. They may also be given antibiotics to prevent an infection.

• A strip of or all your child’s hair is shaved for the cut or cuts.

• The surgeon makes the cut or cuts in your child’s scalp to expose the fused bone.

• The surgeon makes cuts in the bone to open it. Other bones may also be cut to help reshape the skull.

• The surgeon may put absorbable plates or wires between the bones to keep them from moving out of place.

• The surgeon may install a drain at the incision site to remove any fluid that builds up.

• The surgeon closes up the cut or cuts in your child’s head.

What happens after a strip craniectomy?

After the surgery, your child will be taken to the ICU (intensive care unit). Healthcare providers will closely watch your child’s blood pressure, heart rate, and temperature. Your child will be given pain medicine and fluids.

Your child will stay in the hospital for 1 or more days, depending on how they are doing after the surgery. Once at home, make sure your child follows all care instructions. It will take a while for your child to recover. Talk with your child’s healthcare provider if you have any questions or concerns.

Your child may have to wear a custom helmet for some time after the surgery. The helmet helps to reshape your child’s skull. Keep all follow-up appointments with your child’s care team.

Risks of the procedure

A strip craniectomy has the following risks:

• Infection

• Bleeding

• Problems from anesthesia

• Pain or loss of feeling on the scalp

• Brain injury

• Swelling, especially around the eyes

• Scarring

• Cerebrospinal fluid leakage

• Increased pressure in the brain

• Problems from blood transfusion

• Need for another surgery

When to call your child's healthcare provider

Call your child’s healthcare provider right away if your child has any of the following:

• Fever

• Separation of the skin at the incision site

• Drainage, redness, warmth, or swelling at the incision site

• Large collection of fluid under the skin

• Unusual drowsiness

• Weakness of arms or legs

• Headache or visual disturbance

• Seizures

• Vomiting

• Cloudy or foul-smelling urine

• Difficulty breathing