20 February 2026
: Case report 
Fatal Status Epilepticus After Elective Revision Cranioplasty: Case Report and Literature Review
Unusual clinical course, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents
Kate Spuler EF 1, Lola Kaukas
BEF 2, Samuel Tawfik EF 2, Adam Wells EF 2*
DOI: 10.12659/AJCR.951269
Am J Case Rep 2026; 27:e951269
Table 1 Reported cases of status epilepticus after cranioplasty.
| Demographics | Indication | Time to cranioplasty | Material | Presentation | Treatment | Outcome | |
|---|---|---|---|---|---|---|---|
| Zhang et al []23 | Not reported | Not reported | Not reported | Not reported | Not reported | Not reported | Three patients died of recurrent seizures after cranioplasty; no further details reported |
| Klavansky et al []24 | 44 F | Right MCA stroke | 6 months | Not reported | Postoperative day 0 drowsiness; CT demonstrated new right MCA, PCA, and cerebellar hypodensities with subdural hematoma progressing to status epilepticus | AEDs (lorazepam, levetiracetam, lacosamide); sedation (midazolam) | Survived |
| Gooch et al []6 | Not reported | Not reported | 49–99 days | Not reported | Postoperative day 0 status epilepticus | Not reported | Survived |
| Subedi et al []25 | 23 M | TBI | 6 months | Titanium mesh | Postoperative day 2 status epilepticus; CT demonstrated bifrontal tension pneumocephalus and diffuse bilateral cerebral edema | AEDs (levetiracetam, phenytoin, sodium valproate, oxcarbazepine, clobazam, lacosamide); sedation (propofol, midazolam) → cranioplasty removal on postoperative day 7 | Survived; seizure-free at 2-year follow-up with AED therapy |
| Subedi et al []25 | 17 M | TBI | 2 months | Acrylic | Postoperative day 0 extradural hematoma requiring evacuation; postoperative day 2 status epilepticus (CT findings not reported) | AEDs (levetiracetam, phenytoin, sodium valproate, clobazam); sedation (propofol, midazolam) → cranioplasty removal on postoperative day 3 | Survived; seizure-free at 4-year follow-up with AED therapy |
| Apolo et al []26 | 21 M | ICH secondary to ruptured AVM | 9 months | Not reported | Immediate postoperative status epilepticus; CT/MRI demonstrated diffuse bilateral cerebral edema | AEDs, sedation, hypothermia → vagal nerve stimulator | Survived; ongoing but reduced seizure frequency with multiple AEDs and vagal nerve stimulator |
| Chauhan et al []27 | 30 M | TBI | 6 months | Autologous | Immediate postoperative status epilepticus; CT demonstrated no postoperative hemorrhage or hydrocephalus | Mannitol; AEDs (phenytoin, levetiracetam, lorazepam); sedation (propofol, thiopentone) → dexmedetomidine infusion | Survived; seizure-free at 6-month follow-up with AED therapy |
| * Limited case-level detail available. AED – antiepileptic drug; AVM – arteriovenous malformation; CT – computed tomography; ICH – intracranial hemorrhage; MCA – middle cerebral artery; MRI – magnetic resonance imaging; PCA – posterior cerebral artery; TBI – traumatic brain injury. | |||||||