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This meta-analysis included 21 studies involving 1,682 patients, comparing early cranioplasty (≤90 days; n = 691) with later surgery (>90 days; n = 991). Early cranioplasty was associated with better pooled functional outcomes (SMD, 0.52; 95% CI, 0.21–0.83; \(I^2=87.2\%\)) and cognitive recovery measured by MMSE (SMD, 0.57; 95% CI, 0.34–0.79; \(I^2=0\%\)). In traumatic brain injury subgroups, functional outcomes also favored early cranioplasty (SMD, 0.74; 95% CI, 0.32–1.15). Conclusion: Earlier cranioplasty may be associated with better functional and cognitive recovery, but substantial heterogeneity and the largely observational evidence prevent firm causal conclusions.
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This meta-analysis included 21 studies involving 1,682 patients, comparing early cranioplasty (≤90 days; n = 691) with later surgery (>90 days; n = 991). Early cranioplasty was associated with better pooled functional outcomes (SMD, 0.52; 95% CI, 0.21–0.83; \(I^2=87.2\%\)) and cognitive recovery measured by MMSE (SMD, 0.57; 95% CI, 0.34–0.79; \(I^2=0\%\)). In traumatic brain injury subgroups, functional outcomes also favored early cranioplasty (SMD, 0.74; 95% CI, 0.32–1.15). Conclusion: Earlier cranioplasty may be associated with better functional and cognitive recovery, but substantial heterogeneity and the largely observational evidence prevent firm causal conclusions.
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