The influence of decompressive craniectomy on the development of hydrocephalus: a review

Abstract

Decompressive craniectomy (DC) is widely used to treat intracranial hypertension following traumatic brain injury (TBI) or cerebral vascular disease. Many studies have discussed complications of this procedure, and hydrocephalus is a common complication of DC. To further evaluate the relationship between DC and hydrocephalus, a review of the literature was performed. Numerous complications may arise after DC, including contusion or hematoma expansion, epilepsy, herniation of the cortex through a bone defect, CSF leakage through the scalp incision, infection, subdural effusion, hydrocephalus and "syndrome of the trephined". Several hydrocephalus predictors were identified; these included DC, distance from the midline, hygroma, age, injury severity, subarachnoid or intraventricular hemorrhage, delayed time to craniotomy, repeated operation, and duraplasity. However, results differed among studies. The impact of DC on hydrocephalus remains controversial.Keywords: traumatic brain injury, hydrocephalus, decompressive craniectomy. RESUMOA craniectomia descompressiva (CD) é amplamente utilizada para tratar a hipertensão intracraniana após trauma craniencefálico (TC) ou doença cerebrovascular. Vários estudos discutem as complicações deste procedimento, sendo a hidrocefalia uma das complicações mais frequentes. Fizemos uma revisão da literatura para avaliar a relação entre a CD e a hidrocefalia. Podem ocorrer numerosas complicações após a CD, incluindo aumento de volume por contusão ou hematoma, epilepsia e herniação do cortex cerebral através do acesso ósseo. Fístulas liquóricas através a incisão no couro cabeludo, infecções, hematomas subdurais, hidrocefalia e a "síndrome pós-trepanação". Foram identificados vários fatores preditivos de hidrocefalia: a distância da CD em relação à linha média, a ocorrência de higroma, a idade, a gravidade da lesão, a hemorragia subaracnóidea ou intraventricular, o tempo decorrido até a craniectomia, as reoperações e o uso de plástica com dura-máter. Entretanto, há divergências entre os autores e o impacto da CD na hidrocefalia continua controvertido.Palavras-chave: trauma cranencefálico, hidrocefalia, craniectomia descompressiva.

Hydrocephalus Following Giant Transosseous Vertex Meningioma Resection

“…Postoperative hydrocephalus following decompressive craniectomy for either traumatic brain injury or stroke is a welldescribed phenomenon. [13][14][15][16][17][18][19] In each of the cases we presented, the vast amount of transosseous involvement required a large amount of the skull to be permanently removed. This creates a scenario very similar to decompressive craniectomies.…”

Cervical pseudomeningocele-induced hydrocephalus following traumatic brachial plexus injury-–a case report

“…Treatment options include CSF diversion through shunts [17], endoscopic third ventriculostomy with or without septostomy [18,19], and choroid plexus cauterization. In extreme cases, decompressive craniotomy has been performed as a salvage operation [20]. In addition, a lumbar drain represents another viable option, as demonstrated by Manet et al in 2016 [21].…”

Decompressive Hemicraniectomy in Malignant Middle Cerebral Artery Infarction: The ‘Real World' Beyond Studies

“…Most common complications included epidural hematoma, woundhealing disorders and liquid storages like hygromas, which have been reported as acute complications previously [24] . As a typical delayed complication, we identified 4 cases of hydrocephalus requiring a persistent lumbar drainage [25] . Wound infections reflect the large operation field being prone to infections; however, data on wound infection rates in patients undergoing DHC for MMI are scarce.…”