The Biomechanical Mechanism of Cranial Implant Exposure Following Decreased Intracranial Pressure: A Finite Element Analysis Study

Background

Skull prosthesis is widely used for cranioplasty, yet long-term implant exposure remains a challenging complication frequently requiring reoperation. Clinical observations suggest an association between low intracranial pressure (ICP) and progressive scalp thinning, with possible progression to mesh erosion and implant exposure. However, the potential biomechanical mechanism by which dynamic ICP fluctuations may contribute to scalp atrophy and implant exposure has not been characterized owing to limitations of in vivo measurement.