Which surgical procedure carries the risk of delayed brain injury due to the absence of protective skull?

A craniectomy is a surgical procedure that involves the removal of a portion of the skull to alleviate pressure on the brain, often due to swelling from trauma, tumors, or other causes. The procedure creates an absence of protective skull in the area where the craniectomy was performed, leaving the brain more vulnerable to external factors. This can lead to a risk of delayed brain injury because without the protective barrier of the skull, there is a higher chance of damage from environmental impacts, infection, or movement of the brain within the cranial cavity.

In contrast, cranial repair and cranioplasty are procedures aimed at restoring the protective enclosure of the skull after it has been compromised. Cranial repair refers to the skillful reattachment of the skull fragments often seen after trauma, while cranioplasty generally involves reconstructing the skull with synthetic materials or grafts, thereby providing protection to the brain. Laminectomy addresses spinal issues and does not involve the skull; its risks relate to the spine and spinal cord, not delayed brain injury. Thus, the craniectomy is the procedure most relevant to the question regarding delayed brain injury due to the lack of protective skull.