Post-cranioplasty cerebrospinal fluid hydrodynamic changes: Magnetic resonance imaging quantitative analysis

Dujovny, Manuel; Fernandez, Patricia M.; Alperin, Noam; Betz, W.; Misra, Mukesh; Mafee, Mahmood F.

doi:10.1080/01616412.1997.11740818

Cited by 126 publications

(81 citation statements)

References 14 publications

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“…59,89 Decompressive craniectomy also brings about changes in CBF and CSF dynamics. 7,20,24,96,97 Cine MR imaging studies have demonstrated impaired CSF flow across the craniovertebral junction at the skull base, which improves following cranioplasty repair of the skull defect. 20 Decompressive craniectomy also induces a hyperemic response as evidenced by 99m Tc SPECT, 31 P MR imaging, and 133 Xe CT studies demonstrating augmentation of CBF as well as cerebral metabolism.…”

Section: Department Of Neurosurgical Surgery School Of Medicine; Andmentioning

confidence: 99%

“…7,20,24,96,97 Cine MR imaging studies have demonstrated impaired CSF flow across the craniovertebral junction at the skull base, which improves following cranioplasty repair of the skull defect. 20 Decompressive craniectomy also induces a hyperemic response as evidenced by 99m Tc SPECT, 31 P MR imaging, and 133 Xe CT studies demonstrating augmentation of CBF as well as cerebral metabolism. 96,101 Physiological monitoring using CBF, transcranial Doppler, and brain tissue oxygen probes has demonstrated increased CBF and brain tissue oxygen following decompressive craniectomy.…”

Section: Department Of Neurosurgical Surgery School Of Medicine; Andmentioning

confidence: 99%

“…19 Changes in atmospheric pressure, 83 altered CSF circulation, 20,24 and changes in CBF 68,85 have all been proposed to explain the pathophysiology underlying the syndrome. In early studies, a sunken scalp was noted in many patients with syndrome of the trephined (Fig.…”

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confidence: 99%

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Complications of decompressive craniectomy for traumatic brain injury

Stiver¹

2009

FOC

382

302

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Decompressive craniectomy is widely used to treat intracranial hypertension following traumatic brain injury (TBI). Two randomized trials are currently underway to further evaluate the effectiveness of decompressive craniectomy for TBI. Complications of this procedure have major ramifications on the risk-benefit balance in decision-making during evaluation of potential surgical candidates. To further evaluate the complications of decompressive craniectomy, a review of the literature was performed following a detailed search of PubMed between 1980 and 2009. The author restricted her study to literature pertaining to decompressive craniectomy for patients with TBI. An understanding of the pathophysiological events that accompany removal of a large piece of skull bone provides a foundation for understanding many of the complications associated with decompressive craniectomy. The author determined that decompressive craniectomy is not a simple, straightforward operation without adverse effects. Rather, numerous complications may arise, and they do so in a sequential fashion at specific time points following surgical decompression. Expansion of contusions, new subdural and epidural hematomas contralateral to the decompressed hemisphere, and external cerebral herniation typify the early perioperative complications of decompressive craniectomy for TBI. Within the 1st week following decompression, CSF circulation derangements manifest commonly as subdural hygromas. Paradoxical herniation following lumbar puncture in the setting of a large skull defect is a rare, potentially fatal complication that can be prevented and treated if recognized early. During the later phases of recovery, patients may develop a new cognitive, neurological, or psychological deficit termed syndrome of the trephined. In the longer term, a persistent vegetative state is the most devastating of outcomes of decompressive craniectomy. The risk of complications following decompressive craniectomy is weighed against the life-threatening circumstances under which this surgery is performed. Ongoing trials will define whether this balance supports surgical decompression as a first-line treatment for TBI.

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Section: Department Of Neurosurgical Surgery School Of Medicine; Andmentioning

confidence: 99%

Section: Department Of Neurosurgical Surgery School Of Medicine; Andmentioning

confidence: 99%

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Complications of decompressive craniectomy for traumatic brain injury

Stiver¹

2009

FOC

382

302

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“…Dujovny und Mitarbeiter berichteten eine signifikante Veränderung des Liquorflusses sowie eine moderate Steigerung des venösen Rückflusses nach der Kranioplastik [10]. Häufig muss man bei Patienten mit großen Kraniektomiedefekten und gleichzeitig bestehender Störung der Liquorzirkulation im Sinne eines Hydrozephalus zunächst oder gleichzeitig ein ventrikuloperitoneales (VP)-Shuntsystem einbauen.…”

Section: Diskussionunclassified

Kranioplastik nach supratentorieller dekompressiver Kraniektomie

Archavlis

Nievas

2012

Nervenarzt

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“…Craniectomy usually leads to impairment of cerebral blood flow and glucose metabolism, and may also cause changes to the cerebrospinal fluid circulation [2] [3]. Rigid structural reconstruction following craniectomy can release the effects of atmospheric pressure on the brain, and the brain can become dilated [4]- [6].…”

Section: Introductionmentioning

confidence: 99%

Cranioplasty after Decompressive Craniectomy Caused an Intracerebral Hemorrhage: A Case Report

Okumoto¹,

Oji²,

Kishi³

2015

MPS

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Decompressive craniectomy is a common practice for patients with intracranial hypertension. Secondary rigid structural reconstruction following craniectomy can release the effects of atmospheric pressure on the brain, and the brain can become dilated. Although some cases with complications induced by cranioplasty, such as intracranial hematoma, have been reported, no clinical cases with intracerebral hemorrhage after rigid reconstruction have been reported. This case report describes a 39-year-old man with a skull defect following clipping with simultaneous decompressive craniectomy for a subarachnoid hemorrhage. About 25 months later, cranioplasty using a custom-made hydroxyapatite (HAP) ceramic implant was performed. Immediately after the operation, intracerebral hemorrhage was detected on the opposite side by computed tomography (CT). However, there were no physical or neurological findings, the hematoma was completely absorbed within 3 weeks postoperatively, and the skull retained a good shape. This case suggests that rigid reconstruction of a skull defect can influence intracranial conditions, and early postoperative CT is important to detect complications.

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Post-cranioplasty cerebrospinal fluid hydrodynamic changes: Magnetic resonance imaging quantitative analysis

Cited by 126 publications

References 14 publications

Complications of decompressive craniectomy for traumatic brain injury

Complications of decompressive craniectomy for traumatic brain injury

Kranioplastik nach supratentorieller dekompressiver Kraniektomie

Cranioplasty after Decompressive Craniectomy Caused an Intracerebral Hemorrhage: A Case Report

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