The objective of this study is to show a case of cranioplasty, treated with acrylic prosthesis. A 36 years-old man, car accident victim, admitted to the Department of Neurosurgery, at Hospital Estadual Adão Pereira Nunes, in the city of Rio de Janeiro, Brazil. Submitted to pterional craniotomy decompressive of emergency due traumatic brain injury. After 01 years of neurological recovery, the patient was referred to the Oral and Maxillofacial Surgery Department, of the same hospital. Presented clinically with a severe bulging in the fronto-orbital on the left side, associated with mechanical impaction ipsilateral upper eyelid, which precluded the full eye opening, without neurological deficit. Cranial CT examination revealed frontal fragment rotated clockwise, with invasion of orbital cone. Front of case, the proposed treatment was cranioplasty, in order to correct the cosmetic defect, aided prototyping courtesy (CTI ProMED) and customized prosthetic poly-methyl-methacrylate. Under general anesthesia and with coronal access, the bone was exposed, the necessary osteotomies were performed and the prosthesis fixed with system 1.5 (MDT ^® ). There were no accident and trans-operative patient progressed well, been discharged on the seventh postoperative day.

Key words: cranioplasty; prothesis; prototyping