OBJECTIVE: To compare the effect of extensive duraplasty and subsequent early cranioplasty on the recovery of neurological function in management of patients with severe traumatic brain injuries received decompressive craniectomy. METHODS: The computer-aided designation of titanium armor plate was used as a substitute for the repair of skull defect in all the patients. The patients were divided into three groups. Twenty-three patients were in early cranioplasty group who received extensive duraplasty in craniectomy and subsequent cranioplasty within 3 months after previous operation (Group I). Twenty-one patients whose cranioplasty was performed more than 3 months after the first operation were in the group without duraplasty (Group II); while the other 26 patients in the group with duraplasty in previous craniotomy (Group III). Both the Barthel index of activity of daily living (ADL) 3 months after craniotomy for brain injuries and 1 month after cranioplasty and Karnofsky Performance Score (KPS) at least 6 months after cranioplasty were assessed respectively. RESULTS: The occurrence of adverse events commonly seen in cranioplasty, such as incision healing disturbance, fluid collection below skin flap, infection and onset of postoperative epilepsy was not significantly higher than other 2 groups. The ADL scores at 3 months after craniotomy in Groups I-III were 58.9 ± 26.7, 40.8 ± 20.2 and 49.2 ± 18.6. The ADL scores at 1 month after cranioplasty were 70.2 ± 25.2, 50.8 ± 24.8 and 61.2 ± 21.5. The forward KPS scores were 75.4 ± 19.0, 66.5 ± 24.7 and 57.6 ± 24.7 respectively. The ADL and KPS socres were significantly higher in group I than other 2 groups. CONCLUSION: The early cranioplasty in those with extensive duraplasty in previous craniotomy is feasible and helpful to improving ADL and long-term quality of life in patients with severe traumatic brain injuries.
OBJECTIVE: To compare the effect of extensive duraplasty and subsequent early cranioplasty on the recovery of neurological function in management of patients with severe traumatic brain injuries received decompressive craniectomy. METHODS: The computer-aided designation of titanium armor plate was used as a substitute for the repair of skull defect in all the patients. The patients were divided into three groups. Twenty-three patients were in early cranioplasty group who received extensive duraplasty in craniectomy and subsequent cranioplasty within 3 months after previous operation (Group I). Twenty-one patients whose cranioplasty was performed more than 3 months after the first operation were in the group without duraplasty (Group II); while the other 26 patients in the group with duraplasty in previous craniotomy (Group III). Both the Barthel index of activity of daily living (ADL) 3 months after craniotomy for brain injuries and 1 month after cranioplasty and Karnofsky Performance Score (KPS) at least 6 months after cranioplasty were assessed respectively. RESULTS: The occurrence of adverse events commonly seen in cranioplasty, such as incision healing disturbance, fluid collection below skin flap, infection and onset of postoperative epilepsy was not significantly higher than other 2 groups. The ADL scores at 3 months after craniotomy in Groups I-III were 58.9 ± 26.7, 40.8 ± 20.2 and 49.2 ± 18.6. The ADL scores at 1 month after cranioplasty were 70.2 ± 25.2, 50.8 ± 24.8 and 61.2 ± 21.5. The forward KPS scores were 75.4 ± 19.0, 66.5 ± 24.7 and 57.6 ± 24.7 respectively. The ADL and KPS socres were significantly higher in group I than other 2 groups. CONCLUSION: The early cranioplasty in those with extensive duraplasty in previous craniotomy is feasible and helpful to improving ADL and long-term quality of life in patients with severe traumatic brain injuries.
Authors: Peter J Hutchinson; Angelos G Kolias; Tamara Tajsic; Amos Adeleye; Abenezer Tirsit Aklilu; Tedy Apriawan; Abdul Hafid Bajamal; Ernest J Barthélemy; B Indira Devi; Dhananjaya Bhat; Diederik Bulters; Randall Chesnut; Giuseppe Citerio; D Jamie Cooper; Marek Czosnyka; Idara Edem; Nasser M F El-Ghandour; Anthony Figaji; Kostas N Fountas; Clare Gallagher; Gregory W J Hawryluk; Corrado Iaccarino; Mathew Joseph; Tariq Khan; Tsegazeab Laeke; Oleg Levchenko; Baiyun Liu; Weiming Liu; Andrew Maas; Geoffrey T Manley; Paul Manson; Anna T Mazzeo; David K Menon; Daniel B Michael; Susanne Muehlschlegel; David O Okonkwo; Kee B Park; Jeffrey V Rosenfeld; Gail Rosseau; Andres M Rubiano; Hamisi K Shabani; Nino Stocchetti; Shelly D Timmons; Ivan Timofeev; Chris Uff; Jamie S Ullman; Alex Valadka; Vicknes Waran; Adam Wells; Mark H Wilson; Franco Servadei Journal: Acta Neurochir (Wien) Date: 2019-05-28 Impact factor: 2.216
Authors: Ahmed Aloraidi; Ali Alkhaibary; Ahoud Alharbi; Nada Alnefaie; Abeer Alaglan; Abdulaziz AlQarni; Turki Elarjani; Ala Arab; Jamal M Abdullah; Abdulaziz Oqalaa Almubarak; Munzir Abbas; Ibtesam Khairy; Wedad H Almadani; Mohammed Alowhaibi; Abdulaziz Alarifi; Sami Khairy; Ahmed Alkhani Journal: Surg Neurol Int Date: 2021-06-07
Authors: Feng Zheng; Hao Xu; Niklas von Spreckelsen; Pantelis Stavrinou; Marco Timmer; Roland Goldbrunner; Fang Cao; Qishan Ran; Gang Li; Ruiming Fan; Qiang Zhang; Wei Chen; Shengtao Yao; Boris Krischek Journal: J Int Med Res Date: 2018-05-21 Impact factor: 1.671