Comprehensive cognitive and cerebral hemodynamic evaluation after cranioplasty

Coelho, Fernanda; Oliveira, Arthur Maynart Pereira; Paiva, Wellingson Silva; Freire, Fabio Rios; Calado, Vanessa Tomé Gonçalves; Amorim, Robson Luís Oliveira de; Neville, Iuri Santana; Andrade, Almir Ferreira de; Bor‐Seng‐Shu, Edson; Anghinah, Renato; Teixeira, Manoel Jacobsen

doi:10.2147/ndt.s52875

Cited by 15 publications

(7 citation statements)

References 45 publications

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“…Despite the critical variability in terms of injury time (between DC and cranioplasty) in our series, it did not interact with language recovery, as seen in other studies (Coelho et al, 2014; Jelcic et al, 2013).…”

Section: Discussionsupporting

confidence: 49%

“…It is known that, like other psychological procedures, EF are not one-dimensional constructions, being related to different areas in the frontal lobe and functionally connected to other brain regions (Julio-Costa et al, 2018; Malloy-Diniz et al, 2018). Despite the multifactorial nature of EF, which is not fully theorized, there is a relative consensus on the existence of three essential components: inhibition, working memory and cognitive flexibility (Coelho et al, 2014). The scope of this work was restricted to analyzing only these three elements, for pedagogical and objective reasons.…”

Section: Discussionmentioning

confidence: 99%

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Functional improvements associated with cranioplasty after stroke and traumatic brain injury: a cohort study

Coelho,

Noleto,

Solla

et al. 2023

Brain Impairment

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Objective:Decompressive craniectomy is part of the acute management of several neurosurgical illnesses, and is commonly followed by cranioplasty. Data are still scarce on the functional and cognitive outcomes following cranioplasty. We aim to evaluate these outcomes in patients who underwent cranioplasty following traumatic brain injury (TBI) or stroke.Methods:In this prospective cohort, we assessed 1-month and 6-month neuropsychological and functional outcomes in TBI and stroke patients who underwent cranioplasty at a Brazilian tertiary center. The primary outcome was the change in the Digits Test at 1 and 6 months after cranioplasty. Repeated measures general linear models were employed to assess the patients' evolution and interactions with baseline characteristics. Effect size was estimated by the partial η2.Results:A total of 20 TBI and 14 stroke patients were included (mean age 42 ± 14 years; 52.9% male; average schooling 9.5 ± 3.8 years; 91.2% right-handed). We found significant improvements in the Digits Tests up to 6 months after cranioplasty (p = 0.004, partial η2 = 0.183), as well as in attention, episodic memory, verbal fluency, working memory, inhibitory control, visuoconstructive and visuospatial abilities (partial η2 0.106–0.305). We found no interaction between the cranioplasty effect and age, sex or schooling. Patients submitted to cranioplasty earlier (<1 year) after injury had better outcomes.Conclusion:Cognitive and functional outcomes improved after cranioplasty following decompressive craniectomy for stroke or TBI. This effect was consistent regardless of age, sex, or education level and persisted after 6 months. Some degree of spontaneous improvement might have contributed to the results.

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Section: Discussionsupporting

confidence: 49%

Section: Discussionmentioning

confidence: 99%

Functional improvements associated with cranioplasty after stroke and traumatic brain injury: a cohort study

Coelho,

Noleto,

Solla

et al. 2023

Brain Impairment

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“…[ 15 ] In 2014, Coelho et al reported on a patient with TBI who presented with increased cerebral blood flow on CT perfusion and reduction of cognitive impairment following C/P. [ 16 ] Subsequently, Sebastianelli et al (2015) reported on a stroke patient who revealed restoration of hypoperfusion of the DLPFC on electroencephalography concurrent with a reduction of cognitive impairment following C/P. [ 17 ] In 2018, Jiang et al demonstrated improvements to cerebral blood flow to and cerebral blood volume of the frontal lobe after C/P in patients with TBI.…”

Section: Discussionmentioning

confidence: 99%

Changes in the prefronto-thalamic tract following cranioplasty

2021

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Rationale: The prefrontothalamic tract (PTT) injury is associated with various neuropsychological impairments including cognitive impairment. We report on three women with hemorrhagic stroke who showed changes in the PTT following cranioplasty (C/P) using diffusion tensor tractography (DTT) images. Patient concerns: The 3 women with hemorrhagic stroke showed reductions of cognitive impairment following C/P. Mini-Mental State Examination scores (MMSE) were increased by 7-, 8-, and 5-point in patient 1, 2, and 3, respectively, after C/P compared with the patients’ pre-C/P MMSE scores. Diagnosis: Three patients were diagnosed with spontaneous intracerebral hemorrhage. Three patients underwent C/P using auto-bone at 7 (patient 1 and 3) and 13 (patient 2) weeks after onset. Interventions: Diffusion tensor imaging data were acquired within 3 days before and 21 days after C/P. Outcomes: The pre-C/P DTT results showed non-reconstruction of the dorsolateral prefrontal cortex (DLPFC; patient 2 and 3) on the contralateral operation (contra-OP) side and orbitofrontal cortex (OFC; patient 3) on both sides, but those were reconstructed on post-C/P DTT. Except for the contra-OP side OFC of patient 2, all fractional anisotropy values decreased on post-C/P DTT compared with pre-C/P DTT. The mean diffusivity values of the VLPFC and OFC were higher on post-C/P DTT except for the contra-OP side VLPFC of patient 1 and contra-OP side OFC of patient 2. The voxel numbers also increased except for the contra-OP side VLPFC of patient 1. Lessons: We demonstrated structural changes in the PTT along with concomitant reductions of cognitive impairments following C/P in 3 women with hemorrhagic stroke using DTT. The DTT changes suggest that C/P can affect the state of the PTT on both the OP and contra-OP sides. However, the limitation that DTT analysis may underestimate or overestimate fiber tract status due to regions of fiber complexity and crossing fiber should be considered.

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“…11,12 Cranioplasty can potentially reverse these deficits, by minimizing the effects of atmospheric pressure or improving cerebral blood flow and altering cerebrospinal fluid hydrodynamics. [13][14][15] Some authors have reported improvement in patients with syndrome of the trephined, and a decrease in epileptic seizures, following cranioplasty. 10,12,13,16…”

Section: Ementioning

confidence: 99%

Decision-Making in Adult Cranial Vault Reconstruction

Brichacek

Antonyshyn

Edwards

et al. 2021

Plastic &Amp; Reconstructive Surgery

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efects of the cranium may result from various causes: traumatic loss, neurosurgical intervention, skull tumors, infection, and congenital abnormalities. 1 The purpose of cranioplasty is to accurately restore the integrity and surface morphology of the skull using a permanent and durable reconstruction. This is done for both cosmetic and functional purposes. 2 The choice of reconstruction in cranioplasty may be divided into two broad categories: autologous bone and alloplastic materials. Autologous bone provides reparative capabilities and the potential for at least partial consolidation and revascularization. It features superior infection resistance and is less likely to extrude. However, it is also susceptible to resorption, can be difficult to shape, and is associated with donor-site morbidity. 3,4 Alloplastic materials were designed to circumvent these problems. They provide permanent shape and volume retention, but do not incorporate into the skeleton and are more susceptible to both infection and extrusion. 5 The recent advent of computer-designed, patient-specific, three-dimensional implants has revolutionized cranioplasty. Even in experienced

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Comprehensive cognitive and cerebral hemodynamic evaluation after cranioplasty

Cited by 15 publications

References 45 publications

Functional improvements associated with cranioplasty after stroke and traumatic brain injury: a cohort study

Functional improvements associated with cranioplasty after stroke and traumatic brain injury: a cohort study

Changes in the prefronto-thalamic tract following cranioplasty

Decision-Making in Adult Cranial Vault Reconstruction

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