Asymmetric optic nerve sheath diameter as an outcome factor following cranioplasty in patients harboring the 'syndrome of the trephined'

Araújo, António; Arlant, Pedro Alberto; Salvestrini, Arnaldo; Altieri, Carlos Eduardo; Santos, Jasper Guimarães; Pinto, Lauro Figueira; Fazzito, Mirella Martins; Lee, Hae Won; Godoy, Luís Filipe de Souza

doi:10.1590/0004-282x20130176

Cited by 4 publications

(2 citation statements)

References 19 publications

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“…[6][7][8][9][10][11][14][15][16]18,20,21,[26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] Several studies 19,32,[43][44][45][46] have reported an incidence of the syndrome of 1-15% and a time latency of 3-6 months from the DC to the onset of the symptoms.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Cranioplasty on Cerebral Hemodynamics as Measured by Perfusion Computed Tomography and Doppler Ultrasonography

Paredes

Castaño

Cepeda

et al. 2016

Journal of Neurotrauma

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Cranioplasties are performed to protect the brain and correct cosmetic defects, but there is growing evidence that this procedure may result in neurological improvement. We prospectively studied cranioplasties performed at our hospital over a 5-year period. The National Institute of Health Stroke Scale and Barthel index were recorded prior to and within 72 h after the cranioplasty. A perfusion computed tomography (PCT) and transcranial Doppler sonography (TCDS) were performed prior to and 72 h after the surgery. For the PCT, regions irrigated by the anterior cerebral artery, the middle cerebral artery (MCA), the posterior cerebral artery, and the basal ganglia were selected, as well as the mean values for the hemisphere. The sonography was performed in the sitting and the supine position for the MCA and internal carotid. The velocities, pulsatility index, resistance index, and Lindegaard ratio (LR) were obtained, as well as a variation value for the LR (DLR = LR sitting -LR supine). Fifty-four patients were included in the study. Of these, 23 (42.6%) patients presented with objective improvement. The mean cerebral blood flow of the defective side (m-CBF-d) increased from 101.86 to 117.17 mL/100 g/min ( p = 0.064), and the m-CBF of the healthy side (m-CBF-h) increased from 128.14 to 145.73 mL/100 g/min ( p = 0.028). With regard to the TCDS, the DLR was greater on the defective side prior the surgery in those patients who showed improvement (1.295 vs. -0.714; p = 0.002). Cranioplasty resulted in clinical improvement in 40% of the patients, with an increase in the post-surgical CBF. The larger variations in the LR when the patient is moved from the sitting to the supine position might predict the clinical improvement.

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Section: Discussionmentioning

confidence: 99%

The Effect of Cranioplasty on Cerebral Hemodynamics as Measured by Perfusion Computed Tomography and Doppler Ultrasonography

Paredes

Castaño

Cepeda

et al. 2016

Journal of Neurotrauma

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“…De Araujo and colleagues have recently reported on the importance of an asymmetric optic nerve sheath diameter as a possible predictive factor for neurologic improvement following cranioplasty although that was not explored in our study. [ 13 ]…”

Section: Discussionmentioning

confidence: 99%

Clinical spectrum and radiographic features of the syndrome of the trephined

Sedney

Dillen

Julien

2015

Journal of Neurosciences in Rural Practice

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Object:Craniectomy is a common neurosurgical procedure. Syndrome of the trephined (ST) occurring after craniectomy results in neurologic symptoms that are reversible with cranioplasty. While well-documented, previous literature consisted of case reports, symptom spectrum and risk factors have not been well characterized.Materials and Methods:A retrospective review of 29 consecutive cases who underwent decompressive craniectomy within a 30-month period was performed. Patients were considered affected by ST if a previously stable neurological deficit improved within 3 weeks after cranioplasty. Prevalence of ST was measured and association with demographic information, clinical symptoms patterns, indication for and size of craniectomy, as well as radiological signs were tested.Results:Seven patients (24%) developed ST. Chronic rehabilitation arrest was more common than acute neurologic decline. Factors such as craniectomy size and patient age did not reach statistical significance in development of ST. Radiographic factors were predictive, with a sunken skin flap contour being most sensitive, while ventricular effacement was most specific.Conclusion:ST may have a higher incidence than previously thought, with a chronic rehabilitation arrest being a more common presentation than an acute decline. Medical providers involved in the post surgical care and rehabilitation of these patients should maintain a high index of suspicion for ST.

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Historical Vignette Portraying the Difference Between the “Sinking Skin Flap Syndrome” and the “Syndrome of the Trephined” in Decompressive Craniectomy

Beucler¹,

Dagain²

2022

World Neurosurgery

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Asymmetric optic nerve sheath diameter as an outcome factor following cranioplasty in patients harboring the 'syndrome of the trephined'

Cited by 4 publications

References 19 publications

The Effect of Cranioplasty on Cerebral Hemodynamics as Measured by Perfusion Computed Tomography and Doppler Ultrasonography

The Effect of Cranioplasty on Cerebral Hemodynamics as Measured by Perfusion Computed Tomography and Doppler Ultrasonography

Clinical spectrum and radiographic features of the syndrome of the trephined

Historical Vignette Portraying the Difference Between the “Sinking Skin Flap Syndrome” and the “Syndrome of the Trephined” in Decompressive Craniectomy

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