Patient: description of the disease (onset time, main symptoms, hospital, etc.): 08 years an accidental car accident, open an account after the surgery did not make up for the part of the brain need to use titanium plate to make up for the 53 days of the beginning of the hospitalization of the patient has always been in a state of fuzzy consciousness, the 54th day the patient woke up, began to practice talking, walking until now the patient has been able to live independently, but occasionally when talking to the meaning of the expression is not clear. Recuperating at home until now, to the local hospital to consult the doctor told the doctor, such as another operation may be injured brain nerves, so I want to have a senior strength of the hospital to consult. How much does it cost to perform the surgery? Is the patient’s life in danger or will he become a vegetable again? The patient needs to make up the titanium plate 2 centimeters above the left ear, and the area of titanium plate to be made up is about 3-4 centimeters. Hao Xiaoguang, Department of Neurosurgery, Second Hospital of Shandong University: Hello! It should be said that the patient’s recovery is still good. For cranial defect repair surgery, because I did not see the patient’s image data, I can not judge. Generally speaking, the risk of skull repair surgery is not very high. Because cranial bone repair again caused by the patient’s life or lead to more serious dysfunction, mainly may be the defect site is more important, the following brain tissue and scalp soft tissue adhesion is relatively close, the repair process leads to brain tissue damage and dysfunction; or defect range is larger, the brain tissue outward expansion, forced repair after the emergence of intracranial pressure acute increase, or even the emergence of hydrocephalus caused by the life-threatening. Life threatening, etc. According to your description, the area that the patient needs to repair is not very large, and the location is not an important functional area, so I generally judge that it is not very likely that the patient’s life will be in danger because of cranial repair, or that the patient will become a vegetable again. Of course, the exact risk must be examined and combined with the patient’s imaging data, such as CT or MRI, in order to make a more accurate judgment. If you are not confident with the treatment at your local hospital, you may consider taking the patient to a higher level hospital! The above comments are for reference only, good luck! Patient: Hello, Dr. Hao, is it better to use titanium plate or bone marrow mud for cranial repair surgery? Moreover, I heard some people say that the quality of the titanium plate is not good enough to cause itching and other lesions at the repair site after surgery. Is it better to use titanium plates made by that company? Can you give us some good advice? We have been thinking of going to Jinan for repair. There is another question, the patient has been recovering for nearly 2.5 years, and now the right half of the body is often numb, such as: numbness of the right hand or the right leg, can these problems be treated at the same time. Can these problems be treated at the same time, or is the patient already missing this part of the function? Hao Xiaoguang, Department of Neurosurgery, Second Hospital of Shandong University: Hello! There are many types of materials used for cranial repair, the common ones are autologous cranium, bone cement, silicone rubber cranium and titanium plate, etc. Among them, the clinically used materials are mainly autologous cranium, bone cement, silicone rubber cranium and titanium plate. Among them, silicone rubber and titanium plate are commonly used in clinical practice. Each has its own advantages and disadvantages. Silicone rubber skull is pre-shaped, when used according to the use of the site cut, and then fixed with wire or titanium wire, the advantage is cheaper, but because it is a mold made, its shape sometimes and the patient’s defective area around the skull is not very consistent, and therefore may be less aesthetic, but after the growth of a good hair cover, is not completely unacceptable. However, in some areas, due to protrusions or depressions, the silicone rubber can not be well restored to its original shape, and even in some cases, the tension after placement is too high, which may lead to slow breakthrough of the implanted silicone rubber through the scalp, resulting in failure of the repair. Thus, it is still used in clinical practice, but the percentage is relatively low. The titanium plate is not a complete plate, but actually has many regularly arranged slits, similar to a mesh, and thus should be more accurately called titanium mesh. The application of titanium mesh has several advantages: first, it is relatively flexible, easy to cut, can be relatively easy to restore the shape of the missing part, especially at present there is the application of CT scanning after 3D reconstruction technology, you can use the machine will be titanium mesh prior to the molding, so that the shape of its and the missing part of the shape of the basic match, more beautiful. Secondly, as it restores the shape of the original normal skull, the local tension is small, and the titanium mesh itself does not usually break through the scalp due to tension, leading to surgical failure. Third, because it is a titanium material, it can theoretically be scanned with MRI, which will have less of an impact in the future. The main disadvantage of titanium mesh is that it is more expensive, depending on the area of the defective part, its price varies greatly, but the smallest is more than a few thousand dollars, there are some defective parts of the larger, together with the fixation of titanium nails, the cost of materials alone may be more than 10,000 yuan. As for the itchy repair area caused by the poor quality of titanium plates, we have not come across such cases in our hospital. The itchiness of the repair site is not necessarily due to the quality of the material. After two surgeries, the local blood supply of the repair site is still poor, and sometimes the local tissue scar formation leads to greater tension, which may lead to local itching, redness and other manifestations, which may be unavoidable no matter which repair material is used. Therefore, the type of material to be used needs to be decided according to the location and size of the defect, combined with the economic situation. It is best to go to the hospital and have the patient examined by a neurologist who will take into account the patient’s imaging data before making a decision. As for the numbness of the right hand or the right leg, I am not sure when the patient developed this symptom, whether it appeared right after the injury or just now after the injury. According to your description, the patient’s condition after the injury is still relatively serious, and he still needs to practice walking after recovering consciousness, thus the patient’s symptoms are still considered to be caused by the trauma, and it is very difficult to recover from this situation. If the original did not have, now the new symptoms, you should go to the hospital to check the cause.