Syndrome of the trephined following bifrontal decompressive craniectomy: Implications for rehabilitation

Janzen, Courtney; Krüger, Karen; Honeybul, Stephen

doi:10.3109/02699052.2011.635357

Cited by 32 publications

(22 citation statements)

References 28 publications

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“…Further, in recent years, we have witnessed a growing number of papers reporting neurological improvement of patients who underwent a cranioplasty or not whether they suffered from a previous worsening 6,8,16,18,31,34,[47][48][49][50][51] (as originally described by Grant and Norcross). 10,11,13,15,25,27,29,33,35,37,39,48 We decided to measure the improvement between 24 h and 72 h after the procedure because these patients might continue to improve despite the absence of the calvarial bone, and we observed a striking 42% objective improvement and 57% subjective improvement.…”

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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“…Recent studies have shown that cranioplasty may improve the patient's psychological status, social performance, and neurocognitive functioning. 1,14,19,21 The factors that contribute to periprocedural complications, including patients' demographic information, comorbidities, surgical procedure, and under lying disease, need to be thoroughly evaluated. Previous studies that were intended to answer these questions were limited by their design or by their sample size.…”

mentioning

confidence: 99%

Complications following cranioplasty: incidence and predictors in 348 cases

Zanaty

Chalouhi

Starke

et al. 2015

JNS

191

165

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C ranioplasty is more than a cosmetic repair of cranial defects; it is part of the rehabilitation process following a patient's neurological injury. Recent studies have shown that cranioplasty may improve the patient's psychological status, social performance, and neurocognitive functioning. 1,14,19,21 The factors that contribute to periprocedural complications, including patients' demographic information, comorbidities, surgical procedure, and under lying disease, need to be thoroughly evaluated. Previous studies that were intended to answer these questions were limited by their design or by their sample size. Our aim was to evaluate risk factors that predispose patients to an increased risk of cranioplasty complications. Recent evidence in the literature emphasizes patient-specific factors over surgery-specific factors as major predictors of cranioplasty complications. 47,51 It is also becoming evident that surgical treatment for cranioplasty complications is associated with additional surgical procedures. 17,46 In this study, we evaluated the association between patient-specific factors and complications folabbreviatioNs AED = antiepileptic drug; DHC = decompressive hemicraniectomy; DM = diabetes mellitus; SAH = subarachnoid hemorrhage; TBI = traumatic brain injury. obJect The factors that contribute to periprocedural complications following cranioplasty, including patient-specific and surgery-specific factors, need to be thoroughly assessed. The aim of this study was to evaluate risk factors that predispose patients to an increased risk of cranioplasty complications and death. methods The authors conducted a retrospective review of all patients at their institution who underwent cranioplasty following craniectomy for stroke, subarachnoid hemorrhage, epidural hematoma, subdural hematoma, and trauma between January 2000 and December 2011. The following predictors were tested: age, sex, race, diabetic status, hypertensive status, tobacco use, reason for craniectomy, urgency status of the craniectomy, graft material, and location of cranioplasty. The cranioplasty complications included reoperation for hematoma, hydrocephalus postcranioplasty, postcranioplasty seizures, and cranioplasty graft infection. A multivariate logistic regression analysis was performed. Confidence intervals were calculated as the 95% CI. results Three hundred forty-eight patients were included in the study. The overall complication rate was 31.32% (109 of 348). The mortality rate was 3.16%. Predictors of overall complications in multivariate analysis were hypertension (OR 1.92, CI 1.22-3.02), increasing age (OR 1.02, CI 1.00-1.04), and hemorrhagic stroke (OR 3.84,). Predictors of mortality in multivariate analysis were diabetes mellitus (OR 7.56, CI 1.56-36.58), seizures (OR 7.25, CI 1.238-42.79), bifrontal cranioplasty (OR 5.40,, and repeated surgery for hematoma evacuation (OR 13.00, CI 1.51-112.02). Multivariate analysis was also applied to identify the variables that affect the development of seizures, the need for reoperation for hem...

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“…8,[17][18][19][20][21][22][23] A gradual resolution of the subimplant or endocranial dead space was previously reported in 93 percent of our primary cranioplasty patients. 6 In our experience, endocranial dead space greater than 2 cm at the time of implant placement has been associated with 9,15 Obliteration of dead space does not restore normal cerebrospinal fluid circulation and shunt function.…”

Section: Plastic and Reconstructive Surgery • November 2012mentioning

confidence: 93%

Advanced Cranial Reconstruction Using Intracranial Free Flaps and Cranial Bone Grafts

Kumar

Tantawi

Armonda

et al. 2012

Plastic and Reconstructive Surgery

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Syndrome of the trephined following bifrontal decompressive craniectomy: Implications for rehabilitation

Cited by 32 publications

References 28 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

Complications following cranioplasty: incidence and predictors in 348 cases

Advanced Cranial Reconstruction Using Intracranial Free Flaps and Cranial Bone Grafts

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