Post-operative complications of craniotomy and craniectomy

Chughtai, Komal; Nemer, Omar; Kessler, Alexander T.; Bhatt, Alok A.

doi:10.1007/s10140-018-1647-2

Cited by 46 publications

(41 citation statements)

References 28 publications

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“…aortic valve replacement, atrial fibrillation, stents), risk factors for TE (immobilization, prolonged duration of surgery, prone position during surgery, coagulopathy, malignant diseases, infection, comorbidities, history of TE, old age, hemiparesis or hemiplegia) [2,3,[6][7][8][9][10][11][12] are weighed against risk factors for PH (intraoperative bleeding tendency, size and vascularization of the tumor, entity, prolonged operative time, metabolic syndrome). The variety of risk factors and intra-individual differences regarding tumor morphology, AC, and corresponding indication is vast [1,2,[6][7][8]13]. Therefore, our study focused on the search for independent yet widespread, easily measurable risk factors for PH and TE in patients with cranial meningiomas.…”

Section: Clinical and Scientific Backgroundmentioning

confidence: 99%

Perioperative anticoagulation in patients with intracranial meningioma: No increased risk of intracranial hemorrhage?

et al. 2020

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Objective Anticoagulation (AC) is a critical topic in perioperative and post-bleeding management. Nevertheless, there is a lack of data about the safe, judicious use of prophylactic and therapeutic anticoagulation with regard to risk factors and the cause and modality of brain tissue damage as well as unfavorable outcomes such as postoperative hemorrhage (PH) and thromboembolic events (TE) in neurosurgical patients. We therefore present retrospective data on perioperative anticoagulation in meningioma surgery. Methods Data of 286 patients undergoing meningioma surgery between 2006 and 2018 were analyzed. We followed up on anticoagulation management, doses and time points of first application, laboratory values, and adverse events such as PH and TE. Pre-existing medication and hemostatic conditions were evaluated. The time course of patients was measured as overall survival, readmission within 30 days after surgery, as well as Glasgow Outcome Scale (GOS) and modified Rankin Scale (mRS). Statistical analysis was performed using multivariate regression. Results We carried out AC with Fraxiparin and, starting in 2015, Tinzaparin in weight-adapted recommended prophylactic doses. Delayed (216 ± 228h) AC was associated with a significantly increased rate of TE (p = 0.026). Early (29 ± 21.9h) prophylactic AC, on the other hand, did not increase the risk of PH. We identified additional risk factors for PH, such as blood pressure maxima, steroid treatment, and increased white blood cell count. Patients'

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Section: Clinical and Scientific Backgroundmentioning

confidence: 99%

Perioperative anticoagulation in patients with intracranial meningioma: No increased risk of intracranial hemorrhage?

et al. 2020

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“…Regarding the complications detected in craniectomy patients included in our study we found that infection is the most common complication found in 35 (32%) patients followed by extra cranial brain herniation found in 15 (14%) patients, then tension pneumocephalus , intracranial hemorrhage and infarction; each was found in 10 (9%) patients then external brain tamponade, paradoxical herniation and trephine syndrome; each was found in 5 (5%) patients. However, Chughtai et al (2019) found that extracranial brain herniation is the most common complication of the craniectomy. Regarding the complications detected in burr hole patients included in our study, we found postoperative intracranial haemorrhage in 2 (4%) patient.…”

Section: Discussionmentioning

confidence: 99%

MDCT Evaluation of Post-Operative Cranium: Spectrum of Normal Findings & Complications

Eladl¹,

Hassan²,

Eladl³

et al. 2020

ijrps

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Imaging plays an essential role in the evaluation of patients after cranial surgery. Postoperative infection and hemorrhage are common complications after cranial surgeries. Life-threatening complications (like tension and paradoxical herniation) must be identified rapidly at imaging to secure a favorable prognosis. This cross-sectional study included 250 patients who underwent neurosurgical operations and were imaged for the developed postoperative complications using Computed Tomography(CT), Magnetic Resonance Imaging(MRI) with and without contrast. We reviewed the common normal and abnormal findings in post-operative neurosurgical patients. The expected postoperative CT and MRI appearances of these procedures are discussed, followed by complications. These include hemorrhage, tension , wound/soft tissue infection, bone flap infection and abscesses. Complications specifically related to include herniation, external brain , paradoxical herniation, and syndrome. In our study165 male; 58 % and 85 female; 42 % were included; age range (6months-69 years), mean age 34.7 ± 2.9 years. 130 patients underwent , infection (23%) was the most dominant complication followed by cranial hemorrhage (19 %). So to conclude;radiologist must know how to recognize postoperative complications and differentiate them from expected normal findings because an early and accurate diagnosis is important for proper postoperative care. tomography is fast, cost effective, and easily accessible for first-line imaging. Magnetic resonance imaging has higher sensitivity for detecting postoperative infection and ischemia.

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“…Given that cavernous sinus is presumably susceptible to facial infection, orbital cellulitis and sinusitis are also known to cause intracranial abscess [7-9]. Brain abscess is a rare and life-threatening condition that typically originates from direct extension from nearby structures, hematogenous dissemination, or following penetrating cerebral trauma or neurosurgery [8,10].…”

Section: Discussionmentioning

confidence: 99%

Intracranial abscess from facial cellulitis

Park

Kim

et al. 2019

Arch Craniofac Surg

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Cellulitis, one of most common diseases of everyday life, is often overlooked for its significance. Although cellulitis does not cause or lead to serious problems usually, its possibility to cause lifethreatening problem should be known. In present case, a patient who had received acupuncture treatment a week earlier presented to the clinic with symptoms of facial cellulitis. The disease resolved within few weeks under empirical antibiotic treatment but recurred after 3 months. Under close history review of the patient, we found out that the patient had received craniectomy 20 years ago. The patient had blunt headache with no other neurological symptoms that could suspect cranial infection, but considering the risk originating from the patient's surgical history, brain computed tomography (CT) was taken. CT images revealed abscess formation in the subgaleal and epidural spaces. Craniotomy with abscess evacuation was done promptly. With additional antibiotic treatment postoperatively, the disease resolved, and the 1-month postoperative followup brain CT showed no signs of abscess formation.

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Post-operative complications of craniotomy and craniectomy

Cited by 46 publications

References 28 publications

Perioperative anticoagulation in patients with intracranial meningioma: No increased risk of intracranial hemorrhage?

Perioperative anticoagulation in patients with intracranial meningioma: No increased risk of intracranial hemorrhage?

MDCT Evaluation of Post-Operative Cranium: Spectrum of Normal Findings & Complications

Intracranial abscess from facial cellulitis

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