There are various postoperative complications of intracranial operation, such as defects of soft tissue and cranial bone, infection, abscesses, and deformity. We have performed 34 microsurgical free flap transfers to deal with such cases over the past 14 years. Thirty-four patients in those cases underwent neurosurgery as a result of cerebrovascular disease (20 patients), trauma (9), and brain tumors (5). Free flaps were used to repair the cranial defects. A rectus abdominis musculocutaneous (m-c) flap was used in 25 patients, an anterolateral thigh flap was used in 5, a latissimus dorsi m-c flap was used in 1, a tensor fascia lata m-c flap was used in 1, a deep inferior epigastric artery perforator flap was used in 1, and a radial forearm flap was used in 1. Free bone grafts were used to repair skull defects in 21 patients and the dura mater was reconstructed in 7. Problems encountered after reconstruction included local infection, recurrence of dead space, and delayed intracranial abscesses. In two cases, intracranial dead space had been recurrent after reconstruction because of incompetence of intracranial pressure, and was improved to a stable condition after adjusting V-P shunt pressure.
The patients with complications after intracranial surgery had serious problems such as treatment of original cause, esthetic disorder, social difficulty and economical loss. Therefore, positive free flap transfer repairs were important.