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Early cranioplasty associated with a lower rate of post-traumatic hydrocephalus after decompressive craniectomy for
Baris Ozoner1,2, Mustafa Kilic3, Levent Aydin3
1Department of Neurosurgery, School of Medicine, Bahcesehir University, Istanbul, Turkey. drbarisozoner@gmail.com.
Insights
Early cranioplasty within two months after decompressive craniectomy (DC) for traumatic brain injury (TBI) is linked to a reduced risk of post-traumatic hydrocephalus (PTH). This timely intervention may improve patient outcomes.
Area of Science:
- Neurosurgery
- Trauma Care
- Neurology
Background:
- Post-traumatic hydrocephalus (PTH) is a significant complication following traumatic brain injury (TBI).
- Unilateral decompressive craniectomy (DC) is a common surgical intervention for TBI.
- Identifying factors contributing to PTH after DC is crucial for patient management.
Purpose of the Study:
- To determine factors associated with the development of PTH in TBI patients who underwent unilateral DC.
- To investigate the impact of cranioplasty timing on PTH development.
- To evaluate the relationship between PTH and patient outcomes.
Main Methods:
- Retrospective analysis of 126 TBI patients who underwent unilateral DC.
- Patients were categorized into two groups: those who developed PTH (n=25) and those who did not (n=101).
- Comparison of demographic, clinical, radiological, operative, and postoperative factors.
Main Results:
- Cranioplasty performed later than 2 months post-DC was significantly associated with the need for ventriculoperitoneal shunting due to PTH (p < 0.001).
- Patients with PTH showed a significantly higher rate of unfavorable outcomes at 1-year follow-up (Glasgow Outcome Scale-Extended, p = 0.047).
Conclusions:
- Early cranioplasty, performed within 2 months after DC, is associated with a lower incidence of PTH development.
- Timely cranioplasty may be a key factor in preventing PTH and improving long-term outcomes in TBI patients.
Background:
Post-traumatic hydrocephalus (PTH) is one of the primary complications during the course of traumatic brain injury (TBI). The aim of this study was to define factors associated with the development of PTH in patients who underwent unilateral decompressive craniectomy (DC) for TBI.
Methods:
A total of 126 patients, who met the inclusion criteria of the study, were divided into two groups: patients with PTH (n = 25) and patients without PTH (n = 101). Their demographic, clinical, radiological, operative, and postoperative factors, which may be associated with the development of PTH, were compared.
Results:
Multivariate logistic regression analysis revealed that cranioplasty performed later than 2 months following DC was significantly associated with the requirement for ventriculoperitoneal shunting due to PTH (p < 0.001). Also, a significant unfavorable outcome rate was observed in patients with PTH at 1-year follow-up according to the Glasgow Outcome Scale-Extended (p = 0.047).
Conclusions:
Our results show that early cranioplasty within 2 months after DC was associated with a lower rate of PTH development after TBI.
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