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Engineering optimization of decompressive craniectomy based on finite element simulations
Máté Hazay1, Emese Nagy1, Péter Tóth2
1Department of Structural Mechanics, Budapest University of Technology and Economics, Budapest, Hungary.
Acta of Bioengineering and Biomechanics
|November 30, 2021
Summary
Determining the optimal decompressive craniectomy opening size is crucial. This study developed a method for patient-specific optimization and found unilateral openings of 130-180 cm² generally beneficial for reducing brain pressure.
Area of Science:
- Neurosurgery
- Biomechanical Engineering
- Computational Medicine
Background:
- Decompressive craniectomy is a critical procedure for managing increased intracranial pressure.
- Optimal surgical parameters, including skull opening size and location, remain challenging to define.
Purpose of the Study:
- To develop a patient-specific design optimization method for decompressive craniectomy.
- To conduct a large-scale parametric study to guide optimal skull opening in cases of brain edema.
Main Methods:
- Utilized finite element simulations for virtual surgical experiments.
- Employed Goal Programming and Physical Programming for multiobjective optimization.
Main Results:
- Postoperative pressure shows a near-linear relationship with preoperative pressure and opening area.
- Optimal unilateral skull openings range from 130-180 cm², outperforming bifrontal openings.
- Brain tissue damage exhibits a complex, nonlinear response to surgical parameters.
Conclusions:
- Optimal decompressive craniectomy openings are patient-specific, influenced by various input parameters.
- The developed methodology allows for surgical optimization tailored to individual patient data and injury types.
- Parametric study provides generalizable guidelines for approximate optimal skull opening dimensions.
