Fig. 6.

A 65 year old patient with a Lt temporo-parietal post craniectomy defect. B Incision line marked approximately 1.5 cm outside the palpable margins of the bony defect. C Full thickness scalp flap raised exposing the defect site. D 3-D titanium mesh implant contoured, cut and adapted over the defect and fixed to the adjacent bony margins using titanium microscrews. E, F Scalp flap closed in layers, using deep interrupted resorbable sutures for the pericranium and galea, followed by surgical staples for the cutaneous closure. G, H A good cosmetic reconstruction of the cranial defect as well as functional improvement in her motor and cognitive functions as well as her mood and temperament, following the titanium mesh cranioplasty