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December 28, 1963


JAMA. 1963;186(13):1179. doi:10.1001/jama.1963.03710130075028

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To the Editor:  —In the Questions and Answers section of the June 15 issue of The Journal (184:909, 1963) a physician inquired regarding cranioplasty for a 5½-year-old boy with a defect measuring 1% sq in. A defect of this size, in my experience, would be covered by solid bone within a matter of a year or 18 months.Secondly, if the dura is intact, even though the bone defect does not close over completely in large defects, there will be, in my opinion, no significant protrusion of the brain into the defect, and, therefore, no abnormalities (eg, progressive atrophy) will be produced in the cortex.Thirdly, I think it is generally accepted that even moderate-sized defects in children's skulls do not need plastic repair, since the growth process in children's skulls is quite adequate.Lastly, the answer supplied by the consultant seems to me to be quite vague from

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