Basal cisternostomy for traumatic brain injury: A case report of unexpected good recovery

Ramirez, Manuel de Jesus Encarnacion; Castillo, Rossi Evelyn Barrientos; Vorobiev, A. A.; Киселев, Н. С.; Aquino, Amaya Alvarez; Efe, Ibrahim E.

doi:10.1016/j.cjtee.2021.12.008

Cited by 6 publications

(2 citation statements)

References 13 publications

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“…Cisternostomy has been increasingly used in cases of traumatic brain injury (TBI), subarachnoid haemorrhage, arteriovenous malformation (AVM) rupture, tumour, cerebral haemorrhage, and hydrocephalus. [21][22][23] Cisternostomy reduces ICP by opening the cistern in the skull base, including the optic chiasmatic cistern, carotid cistern, endplate cistern, anterior pontine cistern, to release CSF. Cisternostomy causes CSF to move from the swollen brain to the cistern through the Virchow-Robin space, so that the ICP can be decreased effectively.…”

Section: Discussionmentioning

confidence: 99%

Intraventricular haemorrhage treated by extra ventricular drainage with catheter mistakenly penetrating the cisterna ambiens: A case report

Gao,

Yu,

Feng

et al. 2024

J Int Med Res

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Intraventricular haemorrhage (IVH) is a severe and acute type of stroke with a complex pathophysiology and is a therapeutic challenge. This case report described a man in his early 50’s diagnosed with IVH by computed tomography (CT). Although bilateral extraventricular drainage (EVD) was undertaken, a postoperative CT scan showed that while the left catheter was correctly positioned, the right catheter had been wrongly inserted into the cisterna ambiens. The procedure was equivalent to simultaneous EVD combined with cisternostomy. As a consequence, the haematoma was rapidly removed, the risk of infection and long-term hydrocephalus was reduced, and prognosis was improved. Large case-control studies or prospective studies are needed to evaluate the safety and effectiveness of this treatment modality.

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Section: Discussionmentioning

confidence: 99%

Intraventricular haemorrhage treated by extra ventricular drainage with catheter mistakenly penetrating the cisterna ambiens: A case report

Gao,

Yu,

Feng

et al. 2024

J Int Med Res

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“…The interstitial fluid collected within perivenous spaces is then drained to the cervical lymphatic circulation [29]. Basal cisternostomy is a safe and feasible microsurgical procedure for the management of TBI that can effectively evacuate CSF and relax the brain [30]. Compared to DC, basal cisternostomy depends on the use of microsurgical techniques.…”

Section: Discussionmentioning

confidence: 99%

The Role of Cisternostomy in the Management of Severe Traumatic Brain Injury: A Triple-Center Study

Encarnación Ramirez,

Baez,

Marszal Mangbel’ Mikorska

et al. 2023

Surgeries

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Background: Traumatic brain injury (TBI) is a critical public health problem worldwide, constituting a major cause of mortality and morbidity for people of all ages, but especially in the younger population. Decompressive craniectomy (DC) and cisternostomy are surgical procedures commonly used in the management of severe TBI, but their effectiveness in improving outcomes remains controversial. Methods: We conducted a prospective longitudinal study on patients who underwent surgical treatment for severe TBI between 2021 and 2022. The extended Glasgow outcome scale (GOS-E) was used to assess clinical outcome at 2 weeks, 3 months, and 6 months after surgery. Results: The study included 30 patients (21 men and 9 women) who met the inclusion criteria. Among them, 24 patients (80%) underwent DC combined with cisternostomy, while 6 patients (20%) underwent cisternostomy alone. The initial Glasgow Coma Scale (GCS) score at admission ranged from 4 to 8 points, with an average score of 5.9. The overall mortality and overall morbidity was 13.3% and 20%, respectively. The mortality rate was 12.5% and 16.7% in the DC + cisternostomy group and in the cisternostomy alone group, respectively. No statistically significant difference was seen between the two groups in terms of mortality, morbidity and favorable outcome at 2 weeks, 3 months and 6 months. Conclusions: Our preliminary multi-center study shows a good clinical outcome in patients who underwent DC + cisternostomy or cisternostomy alone in both early and long-term follow-up. Larger multi-center randomized trials are needed to establish the effectiveness of cisternostomy in the management of TBI.

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Basal cisternostomy as an adjunct to decompressive hemicraniectomy in moderate to severe traumatic brain injury: a systematic review and meta-analysis

Ciobanu-Caraus,

Percuoco,

Hofer

et al. 2024

Neurosurg Rev

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Background Basal cisternostomy (BC) is a surgical technique to reduce intracranial hypertension following moderate to severe traumatic brain injury (TBI). As the efficacy and safety of BC in patients with TBI has not been well-studied, we aim to summarize the published evidence on the effect of BC as an adjunct to decompressive hemicraniectomy (DHC) on clinical outcome following moderate to severe TBI. Methods A systematic literature review was carried out in PubMed/MEDLINE and EMBASE to identify studies evaluating BC as an adjunct to decompressive hemicraniectomy (DHC) in moderate to severe TBI. Random effects meta-analysis was performed to calculate summary effect estimates. Results Eight studies reporting on 1345 patients were included in the qualitative analysis, of which five (1206 patients) were considered for meta-analysis. Overall, study quality was low and clinical heterogeneity was high. Adjuvant BC (BC + DHC) compared to standalone DHC was associated with a reduction in the length of stay in the ICU (Mean difference [MD]: -3.25 days, 95% CI: -5.41 to -1.09 days, p = 0.003), significantly lower mean brain outward herniation (MD: -0.68 cm, 95% CI: -0.90 to -0.46 cm, p < 0.001), reduced odds of requiring osmotherapy (OR: 0.09, 95% CI: 0.02 to 0.41, p = 0.002) as well as decreased odds of mortality at discharge (OR 0.68, 95% CI: 0.4 to 0.96, p = 0.03). Adjuvant BC compared to DHC did not result in higher odds of a favourable neurological outcome (OR = 2.50, 95% CI: 0.95–6.55, p = 0.06) and did not affect mortality at final follow-up (OR: 0.80, 95% CI: 0.17 to 3.74, p = 0.77). Conclusion There is insufficient data to demonstrate a potential beneficial effect of adjuvant BC. Despite some evidence for reduced mortality and length of stay, there is no effect on neurological outcome. However, these results need to be interpreted with caution as they carry a high risk of bias due to overall scarcity of published clinical data, technical variations, methodological differences, limited cohort sizes, and a considerable heterogeneity in study design and reported outcomes.

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Basal cisternostomy for traumatic brain injury: A case report of unexpected good recovery

Cited by 6 publications

References 13 publications

Intraventricular haemorrhage treated by extra ventricular drainage with catheter mistakenly penetrating the cisterna ambiens: A case report

Intraventricular haemorrhage treated by extra ventricular drainage with catheter mistakenly penetrating the cisterna ambiens: A case report

The Role of Cisternostomy in the Management of Severe Traumatic Brain Injury: A Triple-Center Study

Basal cisternostomy as an adjunct to decompressive hemicraniectomy in moderate to severe traumatic brain injury: a systematic review and meta-analysis

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