Cranial defect and pneumocephalus are associated with significant postneurosurgical positional brain shift:...

Area of Science:

• Neurosurgery
• Radiology
• Medical Imaging

Background:

• Limited research exists on brain shift due to patient repositioning.
• Postneurosurgical positional brain shift (PBS) can impact patient outcomes.

Purpose of the Study:

• To identify factors associated with significant postneurosurgical positional brain shift (PBS).
• To evaluate the prevalence and predictors of clinically significant PBS.

Main Methods:

• Sixty-seven neurosurgery patients underwent upright CT scans.
• Clinically significant PBS was defined as ≥5 mm brain shift.
• Clinical and radiological data were analyzed to find predictors.

Main Results:

• Twenty-one patients (31%) exhibited clinically significant PBS.
• Multivariate analysis identified craniectomy and residual intracranial air volume as predictors.
• In post-craniectomy patients, larger shifts were linked to supratentorial site, parenchymal injury, large defect area, and longer interval from surgery.

Conclusions:

• Craniectomy and residual intracranial air predict significant PBS.
• Factors like craniectomy site, injury type, defect size, and time since surgery influence PBS in post-craniectomy patients.
• Findings support safe mobilization and risk assessment for sinking skin flap syndrome.