Effective treatment via early cranioplasty for intractable contralateral subdural effusion after standard decompressive craniectomy in patients with severe traumatic brain injury

Wan, Yi; Shi, Lei; Wang, Zhimin; Sun, Guan; Pan, Tianhong; Zhang, Shuguang; Zeng, Yanjun

doi:10.1016/j.clineuro.2016.08.004

Cited by 15 publications

(14 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…6 Contralateral SDE in these 13 patients completely resolved or was significantly reduced in the following 1 month and no recurrence was observed in the 6-month follow-up period. 6 Patients that underwent early cranioplasty also experienced benefits compared with those that underwent temporal muscle sticking, including having at least one surgery less, a shorter hospital stay and lower medical costs. 6 These previous studies influenced the decision of the attending physicians treating the current case to perform cranioplasty within 2 months after the DC and this treatment achieved a favourable outcome because the contralateral SDE dissipated quickly after the surgery.…”

Section: Discussionmentioning

confidence: 65%

“…Other theories, such as the disturbance of CSF circulation and flattening of the dicrotic ICP waveform, are also important hypotheses for SDE. 6,13 A previous study reported the normal dicrotic ICP waveform was flattened after hemicraniectomy. 14 As the arachnoid granulations function as pressure-dependent one-way valves, 15 the decreased pulse of the ICP waveform secondary to DC could result in decreased CSF absorption and subsequently lead to SDE.…”

Section: Discussionmentioning

confidence: 98%

“…Studies relevant to cranioplasty as the treatment for contralateral subdural effusion (SDE). 3,6,7,12 hemispheres and brain shift as well, which would finally lead to enlargement of the contralateral subdural space and the accumulation of subdural effusions. 2,12 Patients with clinical deterioration due to contralateral SDE should be treated actively.…”

Section: Discussionmentioning

confidence: 99%

“…Cranioplasty as a new treatment option for contralateral SDE has been reported in recent years. As shown in Table 1, 3,6,7,12 16 cases have been reported whose treatment included cranioplasty. If the two cases that received subduroperitoneal shunt and cranioplasty simultaneously are eliminated, 3,12 only 14 reported cases of contralateral SDE were cured by cranioplasty alone.…”

Section: Discussionmentioning

confidence: 99%

“…6 Patients that underwent early cranioplasty also experienced benefits compared with those that underwent temporal muscle sticking, including having at least one surgery less, a shorter hospital stay and lower medical costs. 6 These previous studies influenced the decision of the attending physicians treating the current case to perform cranioplasty within 2 months after the DC and this treatment achieved a favourable outcome because the contralateral SDE dissipated quickly after the surgery. 3,6,7,12 It should be noted that after cranioplasty, hydrocephalus may occur in some patients after their contralateral SDE has resolved and a further shunt implantation might be necessary.…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Cranioplasty as the treatment for contralateral subdural effusion secondary to decompressive craniectomy: a case report and review of the relevant literature

et al. 2020

View full text Add to dashboard Cite

Subdural effusion (SDE) is a common complication secondary to decompressive craniectomy (DC). This current case report describes a patient with contralateral SDE with a typical clinical course. Initially, he made a good recovery following a head trauma that caused a loss of consciousness and was treated with decompressive craniectomy. However, he only achieved temporary relief after each percutaneous fluid aspiration from an Ommaya reservoir implanted into the cavity of the SDE. He was eventually transferred to the authors’ hospital where he underwent cranioplasty, which finally lead to the reduction and disappearance of his contralateral SDE. Unexpectedly, his clinical condition deteriorated again 2 weeks after the cranioplasty with symptoms of an uncontrolled bladder. A subsequent CT scan found the apparent expansion of the whole cerebral ventricular system, indicating symptomatic communicating hydrocephalus. He then underwent a ventriculoperitoneal shunt procedure, which resulted in a favourable outcome and he was discharged 2 weeks later. A review of the current literature identified only 14 cases of contralateral SDE that were cured by cranioplasty alone. The mechanism of contralateral SDE has been widely discussed. Although the exact mechanism of contralateral SDE and why cranioplasty is effective remain unclear, cranioplasty could be an alternative treatment option for contralateral SDE.

show abstract

Section: Discussionmentioning

confidence: 65%