OBJECT: The optimal timing of cranioplasty after decompressive craniectomy for stroke is not known. Case series suggest that early cranioplasty is associated with higher rates of infection while delaying cranioplasty may be associated with higher rates of bone resorption. The authors examined whether the timing of cranioplasty after decompressive craniectomy for stroke affects postoperative complication rates. METHODS: A retrospective cohort study was undertaken to evaluate complication rates in patients undergoing cranioplasty at early (within 10 weeks of craniectomy) or late (≥ 10 weeks) stages. Multivariate logistic regression analysis was used to determine characteristics that would predict complications in patients undergoing cranioplasty after decompressive craniectomy for stroke. RESULTS: While the overall complication rate was higher in the early cranioplasty cohort (22% vs 16% in the late cranioplasty cohort), the difference was not statistically significant (p = 0.5541). Patients in the early cranioplasty cohort had lower rates of postoperative hematoma but higher rates of infection. Presence of a CSF shunt was the only significant predictor of complications (OR 8.96, 95% CI 1.84-43.6). CONCLUSIONS: Complications rates for early cranioplasty (within 10 weeks of craniectomy) are similar to those encountered when cranioplasty is delayed, although the cohort size in this study was too small to state equivalence. Patients with a ventriculoperitoneal shunt are at higher risk for complications after cranioplasty.
OBJECT: The optimal timing of cranioplasty after decompressive craniectomy for stroke is not known. Case series suggest that early cranioplasty is associated with higher rates of infection while delaying cranioplasty may be associated with higher rates of bone resorption. The authors examined whether the timing of cranioplasty after decompressive craniectomy for stroke affects postoperative complication rates. METHODS: A retrospective cohort study was undertaken to evaluate complication rates in patients undergoing cranioplasty at early (within 10 weeks of craniectomy) or late (≥ 10 weeks) stages. Multivariate logistic regression analysis was used to determine characteristics that would predict complications in patients undergoing cranioplasty after decompressive craniectomy for stroke. RESULTS: While the overall complication rate was higher in the early cranioplasty cohort (22% vs 16% in the late cranioplasty cohort), the difference was not statistically significant (p = 0.5541). Patients in the early cranioplasty cohort had lower rates of postoperative hematoma but higher rates of infection. Presence of a CSF shunt was the only significant predictor of complications (OR 8.96, 95% CI 1.84-43.6). CONCLUSIONS: Complications rates for early cranioplasty (within 10 weeks of craniectomy) are similar to those encountered when cranioplasty is delayed, although the cohort size in this study was too small to state equivalence. Patients with a ventriculoperitoneal shunt are at higher risk for complications after cranioplasty.
Authors: David B Kurland; Ariana Khaladj-Ghom; Jesse A Stokum; Brianna Carusillo; Jason K Karimy; Volodymyr Gerzanich; Juan Sahuquillo; J Marc Simard Journal: Neurocrit Care Date: 2015-10 Impact factor: 3.210
Authors: Kingsley O Abode-Iyamah; Hsiu-Yin Chiang; Nolan Winslow; Brian Park; Mario Zanaty; Brian J Dlouhy; Oliver E Flouty; Zachary D Rasmussen; Loreen A Herwaldt; Jeremy D Greenlee Journal: J Neurosurg Date: 2017-05-12 Impact factor: 5.115
Authors: Igor Paredes; Ana María Castaño; Santiago Cepeda; Jose Antonio Fernández Alén; Elena Salvador; Jose María Millán; Alfonso Lagares Journal: J Neurotrauma Date: 2016-01-28 Impact factor: 5.269
Authors: Christian Ewald; Pedro Duenisch; Jan Walter; Theresa Götz; Otto W Witte; Rolf Kalff; Albrecht Günther Journal: Neurocrit Care Date: 2014-02 Impact factor: 3.210
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