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CT perfusion studies and cranioplasty

Perikal J Parichay, Kiran Khanapure, Krishna C Joshi, T J Aniruddha, M Sandhya, A S Hegde
OBJECTIVES: To find the correlation between radiologically proven improvement in cerebral hemodynamics with clinical improvement in patients undergoing cranioplasty. MATERIAL AND METHODS: The study is a prospective observational study of 10 cases, in M S Ramaiah Institute of Neurosciences, involving patients treated by a decompressive craniectomy for intractable intra cranial hypertension either due to trauma or stroke and afterwards underwent cranioplasty. RESULTS: Of the 10 patients, 70% patients showing significant improvement in motor functions on Barthel index scale, 60% patients showed improvement in speech, mean duration from date of decompressive craniectomy to cranioplasty being 122...
August 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Sameer H Halani, Jason K Chu, James G Malcolm, Rima S Rindler, Jason W Allen, Jonathan A Grossberg, Gustavo Pradilla, Faiz U Ahmad
BACKGROUND: Cranioplasty after decompressive craniectomy (DC) is routinely performed for reconstructive purposes and has been recently linked to improved cerebral blood flow (CBF) and neurological function. OBJECTIVE: To systematically review all available literature to evaluate the effect of cranioplasty on CBF and neurocognitive recovery. METHODS: A PubMed, Google Scholar, and MEDLINE search adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines included studies reporting patients who underwent DC and subsequent cranioplasty in whom cerebral hemodynamics were measured before and after cranioplasty...
August 1, 2017: Neurosurgery
Igor Paredes, Ana María Castaño, Santiago Cepeda, Jose Antonio Fernández Alén, Elena Salvador, Jose María Millán, Alfonso Lagares
Cranioplasties are performed to protect the brain and correct cosmetic defects, but there is growing evidence that this procedure may result in neurological improvement. We prospectively studied cranioplasties performed at our hospital over a 5-year period. The National Institute of Health Stroke Scale and Barthel index were recorded prior to and within 72 h after the cranioplasty. A perfusion computed tomography (PCT) and transcranial Doppler sonography (TCDS) were performed prior to and 72 h after the surgery...
September 1, 2016: Journal of Neurotrauma
Liang Wen, Hai-Yan Lou, Jun Xu, Hao Wang, Xin Huang, Jiang-Biao Gong, Bin Xiong, Xiao-Feng Yang
BACKGROUND: A large cranial defect following decompressive craniectomy (DC) is a common sequela in patients with severe traumatic brain injury (TBI). Such a defect can cause severe disturbance of cerebral blood flow (CBF) regulation. This study investigated the impact of cranioplasty on CBF in these patients. METHODS: Patients who underwent DC and secondary cranioplasty were prospectively studied for a severe TBI. CT perfusion was used to measure CBF before and after cranioplasty...
2015: Brain Injury: [BI]
Silvio Sarubbo, Francesco Latini, Stefano Ceruti, Arturo Chieregato, Christopher d'Esterre, Ting-Yim Lee, Michele Cavallo, Enrico Fainardi
INTRODUCTION: Little is known about hemodynamic disturbances affecting cerebral hemispheres in traumatic brain injury (TBI) after cranioplasty. METHODS: We prospectively investigated six stable TBI patients who underwent cranioplasty more than 90 days after effective decompressive craniectomy. Computerized tomography perfusion (CTP) studies and evaluation of clinical outcome were performed for each patient before cranioplasty and at 7 days and 3 months after surgery...
March 2014: Neuroradiology
Chibbaro Salvatore, Vallee Fabrice, Marsella Marco, Tigan Leonardo, Lilin Thomas, Lecuelle Benoit, George Bernard, Kehrli Pierre, Vicaut Eric, Diemidio Paolo
BACKGROUND: Decompressive craniectomy (DC) is a procedure performed increasingly often in current neurosurgical practice. Significant perioperative morbidity may be associated to this procedure because of the large skull defect; also, later closure of the skull defect (cranioplasty) may be associated to post-operative morbidity as much as any other reconstructive operation. The authors present a newly conceived/developed device: The "Skull Flap" (SF). This system, placed at the time of the craniectomy, offers the possibility to provide cranial reconstruction sparing patients a second operation...
October 2013: Journal of Neurosciences in Rural Practice
N Decaminada, P Pernter, A Imondi, A Tomassini
CT Perfusion imaging is usually applied to assess perfusion abnormalities in acute stroke. This prospective study applied the technique to monitor cerebral haemodynamics before and after cranioplasty. Cranioplasty is the surgical correction of a skull defect using autologous or heterologous material to obtain cosmetic repair, restoration of brain protection and neurological improvement (1). As far as we know the effect of cranioplasty on cerebral haemodynamics flow has been analysed by CT perfusion only in one article (2)...
October 1, 2008: Neuroradiology Journal
S Chibbaro, F Vallee, K Beccaria, P Poczos, O Makiese, M Fricia, J Mateo, C Gobron, J-P Guichard, A Romano, B Levy, B George, E Vicaut
INTRODUCTION: Cranioplasty after decompressive craniectomy in patients suffering from severe head injury often leads to a functional improvement although, to date, the pathophysiology of this phenomenon remains unclear. A few hypotheses have been proposed. The impact of cranioplasty on cerebral perfusion could be one explanation. We have evaluated the impact of cranioplasty on the functional status of patients undergoing decompressive craniectomy for severe head injury with its influence on cerebral perfusion...
March 2013: Revue Neurologique
Yoo-Dong Won, Do-Sung Yoo, Ki-Tae Kim, Suck-Gu Kang, Sang-Bock Lee, Dal-Soo Kim, Seong-Tai Hahn, Pil-Woo Huh, Kyung-Suck Cho, Chun-Kun Park
BACKGROUND: Cranioplasty is usually performed for aesthetic, protective and patient comfort reasons. The objective of this study is to examine the effects of cranioplasty on the cerebral hemodynamics and cardiovascular system. METHODS: Twenty-seven patients who had undergone cranioplasty after extensive skull bone removal to prevent uncontrollable intracranial hypertension were included in this study. Arterial blood flow velocities in the middle cerebral artery (MCA) and internal carotid artery (ICA) were assessed by transcranial doppler (TCD)...
2008: Acta Neurochirurgica. Supplement
Shirley I Stiver, Max Wintermark, Geoffrey T Manley
OBJECT: The "syndrome of the trephined" is an uncommon and poorly understood disorder of delayed neurological deficit following craniectomy. From the authors' extensive experience with decompressive hemicraniectomy for traumatic brain injury (TBI), they have encountered a number of patients who developed delayed motor deficits, also called "motor trephine syndrome," and reversal of the weakness following cranioplasty repair. The authors set out to study motor function systematically in this patient population to define the incidence, contributing factors, and outcome of patients with motor trephine syndrome...
August 2008: Journal of Neurosurgery
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