PRIMARY OBJECTIVE: Decompressive craniectomy is an effective therapy to relieve intractable intracranial hypertension following acute brain injury. However, little is known about the optimal timing for cranioplasties in the sub-acute phase. The objective of the present study was to analyse the effect of cranioplasty timing on neurological outcomes. RESEARCH DESIGN: Single-centre observational study. METHODS AND PROCEDURES: One hundred and forty-seven consecutive patients with decompressive craniectomy and cranioplasty during the course of inpatient neurorehabilitation were identified by means of a retrospective hospital database search. This database contains the following prospectively-entered weekly scores: Barthel-Index (BI), Functional Independence Measure (FIM) and Coma Remission Scale (CRS). Additional clinical data were taken retrospectively from patient charts. Regression analysis was used to identify factors that influenced the end-of-rehabilitation outcome. MAIN OUTCOMES AND RESULTS: Patients with shorter delays to cranioplasty (<86 days) had a better functional outcome than patients with longer delays of >85 days (60 ± 29.5 versus 25 ± 24.1 BI points; p < 0.01, respectively). Age, pre-operative BI and CRS scores were additional independent outcome factors. Complication rates were not different between early and late cranioplasty groups. CONCLUSIONS: Patients with decompressive craniectomy for management of intracranial hypertension may benefit from early cranioplasty.
PRIMARY OBJECTIVE: Decompressive craniectomy is an effective therapy to relieve intractable intracranial hypertension following acute brain injury. However, little is known about the optimal timing for cranioplasties in the sub-acute phase. The objective of the present study was to analyse the effect of cranioplasty timing on neurological outcomes. RESEARCH DESIGN: Single-centre observational study. METHODS AND PROCEDURES: One hundred and forty-seven consecutive patients with decompressive craniectomy and cranioplasty during the course of inpatient neurorehabilitation were identified by means of a retrospective hospital database search. This database contains the following prospectively-entered weekly scores: Barthel-Index (BI), Functional Independence Measure (FIM) and Coma Remission Scale (CRS). Additional clinical data were taken retrospectively from patient charts. Regression analysis was used to identify factors that influenced the end-of-rehabilitation outcome. MAIN OUTCOMES AND RESULTS:Patients with shorter delays to cranioplasty (<86 days) had a better functional outcome than patients with longer delays of >85 days (60 ± 29.5 versus 25 ± 24.1 BI points; p < 0.01, respectively). Age, pre-operative BI and CRS scores were additional independent outcome factors. Complication rates were not different between early and late cranioplasty groups. CONCLUSIONS:Patients with decompressive craniectomy for management of intracranial hypertension may benefit from early cranioplasty.
Authors: Igor Paredes; José Antonio F Alén; Ana María Castaño-León; Pedro-Antonio Gómez; Luis Jimenez-Roldán; Irene Panero; Carla Eiriz; Daniel García-Perez; Luis Miguel Moreno; Olga Esteban-Sinovas; Pedro Gonzalez-León; Ángel Perez-Nuñez; Pablo M Munarriz; Alfonso Lagares de Toledo; Alfonso Lagares Journal: Neurosurg Rev Date: 2021-10-09 Impact factor: 3.042
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: Luca Sebastianelli; Verena Stoll; Viviana Versace; Sara Martignago; Stephan Obletter; Marco Lavoriero; Kathrin Malfertheiner; Gertraud Gisser; Leopold Saltuari Journal: Case Rep Neurol Med Date: 2015-10-27
Authors: Jong Min Lee; Kum Whang; Sung Min Cho; Jong Yeon Kim; Ji Woong Oh; Youn Moo Koo; Chul Hu; Jin Soo Pyen; Jong Wook Choi Journal: Korean J Neurotrauma Date: 2017-10-31
Authors: Maria C De Cola; Francesco Corallo; Deborah Pria; Viviana Lo Buono; Rocco S Calabrò Journal: Brain Behav Date: 2018-10-02 Impact factor: 2.708