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Decompressive craniectomy

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https://www.readbyqxmd.com/read/28230585/decompressive-craniectomy-with-bifrontal-coronal-incision-in-the-management-of-fronto-temporal-contusion-and-laceration-for-early-cranioplasty
#1
Zhong Wang, Ning Su, Ri-Le Wu, Yi-Song Zhang, Xiao-Jun Zhang, Jian-Jun Qi, Wei-Ping Zhao, Zhong Zhang, Jun-Qing Wang
The present study aims to explore the effectiveness of decompressive craniectomy with bifrontal coronal incision in the management of severe contusion and laceration of bilateral fronto-temporal lobes, as well as the outcomes of early cranioplasty. The authors performed the bifrontal decompressive craniectomy on 56 patients with contusion and laceration of bilateral frontal and temporal lobes, and their follow-up treatment outcomes were tracked within 6 months using Glasgow Outcome Scale. The results showed that 33 patients (out of 56, 58...
February 22, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28226284/does-suboccipital-decompression-and-evacuation-of-intraparenchymal-hematoma-improve-neurological-outcome-in-patients-with-spontaneous-cerebellar-hemorrhage
#2
Katharina A M Hackenberg, Andreas W Unterberg, Carla S Jung, Julian Bösel, Silvia Schönenberger, Klaus Zweckberger
OBJECTIVE: Spontaneous cerebellar hemorrhages (SCH) can lead to life-threatening complications with high mortality rates of 20-50%. Although complications of SCH can be prevented by surgical therapy, there is a lack of consensus concerning the optimal surgical technique for evacuating SCH. METHODS: In this retrospective study 85 patients with SCH were divided into four treatment groups: (1) Decompression and Hematoma Evacuation via suboccipital craniectomy and removal of the posterior arch of C1 (DHE)...
February 3, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28225527/neuro-trauma-or-med-surg-intensive-care-unit-does-it-matter-where-multiple-injuries-patients-with-traumatic-brain-injury-are-admitted-secondary-analysis-of-the-american-association-for-the-surgery-of-trauma-multi-institutional-trials-committee-decompressive
#3
Sarah Lombardo, Thomas Scalea, Jason Sperry, Raul Coimbra, Gary Vercruysse, Toby Enniss, Gregory J Jurkovich, Raminder Nirula
INTRODUCTION: Patients with nontraumatic acute intracranial pathology benefit from neurointensivist care. Similarly, trauma patients with and without traumatic brain injury (TBI) fare better when treated by a dedicated trauma team. No study has yet evaluated the role of specialized neurocritical (NICU) and trauma intensive care units (TICU) in the management of TBI patients, and it remains unclear which TBI patients are best served in NICU, TICU, or general (Med/Surg) ICU. METHODS: This study is a secondary analysis of The American Association for the Surgery of Trauma Multi-Institutional Trials Committee (AAST-MITC) decompressive craniectomy study...
March 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28223249/predicted-unfavorable-neurological-outcome-is-overestimated-by-the-marshall-ct-score-crash-and-impact-models-in-severe-tbi-patients-management-with-early-decompressive-craniectomy
#4
Jose D Charry, Jorman H Tejada, Miguel A Pinzon, Wilson A Tejada, Juan D Ochoa, Manuel Falla, Jesus H Tovar, Ana M Cuellar-Bahamón, Juan P Solano
INTRODUCTION: Traumatic Brain Injury (TBI) is of public health interest and produces significant mortality and disability in Colombia. Calculators and prognostic models have been developed in order to establish neurologic outcome. We tested prognostic models (the Marshall CT score, IMPACT, and CRASH) for 14-day mortality, 6-month mortality, and 6-month outcome in TBI patients in a university Hospital in Colombia. METHODS: A 127 patients' cohort with TBI was treated in a regional trauma center in Colombia over 2 years and Bivariate and Multivariate analyses were used...
February 18, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28216211/the-association-of-surgical-method-with-outcomes-of-acute-subdural-hematoma-patients-experience-with-643-consecutive-patients
#5
Rimantas Vilcinis, Adomas Bunevicius, Arimantas Tamasauskas
OBJECTIVE: Optimal surgical management strategy of acute subdural hematoma (ASDH) patients is challenging. We investigated the association of decompressive craniectomy (DC) and osteoplastic craniotomy (OC) with outcomes in consecutive patients undergoing surgical evacuation of ASDH, and analyzed prognostic indicators. METHODS: We reviewed prospective institutional database of all adult ASDH patients operated by craniotomy from January, 2009 until January, 2016. Mortality and discharge outcomes (Glasgow outcomes scale or GOS) were analyzed as a function of surgical method adjusting for age, admission GCS, ASDH thickness and midline shift...
February 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28203185/reversible-cerebral-vasoconstriction-syndrome-with-intracranial-hypertension-should-decompressive-craniectomy-be-considered
#6
Ségolène Mrozek, Laurent Lonjaret, Aude Jaffre, Anne-Christine Januel, Nicolas Raposo, Sergio Boetto, Jean-François Albucher, Olivier Fourcade, Thomas Geeraerts
BACKGROUND: Reversible cerebral vasoconstriction syndrome (RCVS) is a rare cause of intracerebral hemorrhage (ICH) causing intracranial hypertension. METHODS: Case report. RESULTS: We report a case of RCVS-related ICH leading to refractory intracranial hypertension. A decompressive craniectomy was performed to control intracranial pressure. We discuss here the management of RCVS with intracranial hypertension. Decompressive craniectomy was preformed to avoid the risky option of high cerebral perfusion pressure management with the risk of bleeding, hemorrhagic complications, and high doses of norepinephrine...
January 2017: Case Reports in Neurology
https://www.readbyqxmd.com/read/28187804/decompressive-craniectomy-in-acute-brain-injury
#7
D A Brown, E F M Wijdicks
Decompressive surgery to reduce pressure under the skull varies from a burrhole, bone flap to removal of a large skull segment. Decompressive craniectomy is the removal of a large enough segment of skull to reduce refractory intracranial pressure and to maintain cerebral compliance for the purpose of preventing neurologic deterioration. Decompressive hemicraniectomy and bifrontal craniectomy are the most commonly performed procedures. Bifrontal craniectomy is most often utilized with generalized cerebral edema in the absence of a focal mass lesion and when there are bilateral frontal contusions...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28181025/surgical-management-of-chiari-i-malformation-based-on-different-cerebrospinal-fluid-flow-patterns-at-the-cranial-vertebral-junction
#8
Tao Fan, HaiJun Zhao, XinGang Zhao, Cong Liang, YinQian Wang, QiFei Gai
Chiari I malformation has been shown to present different cerebrospinal fluid (CSF) flow patterns at the cranial-vertebral junction (CVJ). Posterior fossa decompression is the first-line treatment for symptomatic Chiari I malformation. However, there is still controversy on the indication and selection of decompression procedures. This research aims to investigate the clinical indications, outcomes, and complications of the decompression procedures as alternative treatments for Chiari I malformation, based on the different CSF flow patterns at the cranial-vertebral junction...
February 9, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28178299/a-simple-prediction-score-system-for-malignant-brain-edema-progression-in-large-hemispheric-infarction
#9
KwangWook Jo, Suhas S Bajgur, Hoon Kim, Huimahn A Choi, Pil-Woo Huh, Kiwon Lee
Malignant brain edema (MBE) due to hemispheric infarction can result in brain herniation, poor outcomes, and death; outcome may be improved if certain interventions, such as decompressive craniectomy, are performed early. We sought to generate a prediction score to easily identify those patients at high risk for MBE. 121 patients with large hemispheric infarction (LHI) (2011 to 2014) were included. Patients were divided into two groups: those who developed MBE and those who did not. Independent predictors of MBE were identified by logistic regression and a score was developed...
2017: PloS One
https://www.readbyqxmd.com/read/28163065/a-standardized-method-to-measure-brain-shifts-with-decompressive-hemicraniectomy
#10
Askiel Bruno, Abdurrehman Zahran, Nina Paletta, Laith Maali, Fenwick T Nichols, Ramon Figueroa
BACKGROUND: A standardized, reliable, and practical method for measuring decompressive hemicraniectomy (DHC) defects and brain shifts in malignant middle cerebral artery (MCA) territory infarction is needed for reliable comparisons between computed tomography (CT) scans. Such a method could facilitate further studies on the effects of DHC. NEW METHOD: We describe and apply a method for measuring DHC defects and brain shifts on CT scans in 25 patients with malignant MCA territory infarction...
February 2, 2017: Journal of Neuroscience Methods
https://www.readbyqxmd.com/read/28160738/on-the-mechanical-behaviour-of-peek-and-ha-cranial-implants-under-impact-loading
#11
D Garcia-Gonzalez, J Jayamohan, S N Sotiropoulos, S-H Yoon, J Cook, C R Siviour, A Arias, A Jérusalem
The human head can be subjected to numerous impact loadings such as those produced by a fall or during sport activities. These accidents can result in skull fracture and in some complex cases, part of the skull may need to be replaced by a biomedical implant. Even when the skull is not damaged, such accidents can result in brain swelling treated by decompressive craniectomy. Usually, after recovery, the part of the skull that has been removed is replaced by a prosthesis. In such situations, a computational tool able to analyse the choice of prosthesis material depending on the patient's specific activity has the potential to be extremely useful for clinicians...
January 10, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28137550/intraoperative-indocyanine-green-icg-based-cortical-perfusion-assessment-in-patients-suffering-from-severe-traumatic-brain-injury
#12
Marcel A Kamp, Sevgi Sarikaya-Seiwert, Athanasios K Petridis, Thomas Beez, Jan-Frederick Cornelius, Hans-Jakob Steiger, Bernd Turowski, Philipp J Slotty
The pathophysiology of traumatic brain injury (TBI) largely involves the brains vascular structural integrity. We analyzed the value of an intraoperative cortical ICG-angiography in patients with severe TBI and acute subdural hematoma who underwent decompressive craniectomy. Indocyanine green (ICG)-derived fluorescence curves of cortex and cerebral vessels were recorded using a software integrated into a surgical microscope in 10 patients. The maximum intensity, rise time (RT), time to peak (TTP) and residual fluorescence intensity (FI) were estimated from cortical arteries, the parenchyma and veins...
January 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28137547/repeat-intracranial-expansion-after-skull-re-growth-in-hyperostotic-disease-a-technical-note
#13
Timothy Wong, Yehuda Herschman, Nitesh V Patel, Tushar Patel, Simon Hanft
OBJECTIVE: and Importance: Camurati-Engelmann's disease (CED) is a rare, autosomal dominant genetic disorder resulting in hyperostosis of the long bones and skull.(1-4) Patients often develop cranial nerve dysfunction and increased intracranial pressure secondary to stenosis of nerve foramina and hyperostosis.(1-11) Surgical decompression may provide symptomatic relief in select patients; however, a small number of reports document the recurrence of symptoms due to bony regrowth.(1, 6, 7, 9-11) We present a patient who had previously been treated with bilateral frontal and parietal craniotomy that experienced recurrence of symptoms due to re-ossification of her cranial bones...
January 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28108618/timing-of-decompressive-hemicraniectomy-for-stroke-a-nationwide-inpatient-sample-analysis
#14
Hormuzdiyar H Dasenbrock, Faith C Robertson, Henrikas Vaitkevicius, M Ali Aziz-Sultan, Donovan Guttieres, Ian F Dunn, Rose Du, William B Gormley
BACKGROUND AND PURPOSE: Previous clinical trials were not designed to discern the optimal timing of decompressive craniectomy for stroke, and the ideal surgical timing in patients with space-occupying infarction who do not exhibit deterioration within 48 hours is debated. METHODS: Patients undergoing decompressive craniectomy for stroke were extracted from the Nationwide Inpatient Sample (2002-2011). Multivariable logistic regression evaluated the association of surgical timing with mortality, discharge to institutional care, and poor outcome (a composite end point including death, tracheostomy and gastrostomy, or discharge to institutional care)...
January 20, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28100862/-bone-flap-resorption-after-cranioplasty-in-pediatric-patients-report-of-2-cases
#15
Rintaro Yokoyama, Takeshi Mikami, Shouhei Noshiro, Kei Miyata, Kentaro Toyama, Katsuya Komatsu, Noriaki Kikuchi, Tadashi Hasegawa, Nobuhiro Mikuni
Aseptic bone flap resorption, a rare complication after cranioplasty following decompressive craniectomy, is more likely to develop in children. We experienced two cases of aseptic bone flap resorption and identified potential pathophysiological mechanisms through histological findings. In the first case, an 11-year-old girl underwent decompressive craniectomy due to brain swelling with contusion. An autologous bone flap was cryopreserved for four months. Twenty-five months after cranioplasty with autologous bone flap, aseptic bone flap resorption was observed, and cranioplasty was performed with ceramic bone...
January 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28087433/exploration-of-the-most-effective-dural-incision-design-in-a-decompressive-craniectomy
#16
Mutsumi Nagai, Mami Ishikawa
OBJECTIVE: During a decompressive craniectomy performed for a severe cerebral infarction, sufficient coverage of the underlying bulging brain by converting the flat dura mater to a more dome-like shape is essential. In this procedure, suturing to patch dural substitutes on the dural rifts occupies most of the operative time and is cumbersome. We present a new dural incision design that provides an appropriate volume of subdural space with minimal incisions. METHODS: The ideal incision design was geometrically analyzed and verified by simulations using a physics engine...
January 10, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28072702/hypersomnia-due-to-injury-of-the-ventral-ascending-reticular-activating-system-following-cerebellar-herniation-a-case-report
#17
Sung Ho Jang, Chul Hoon Chang, Young Jin Jung, Hyeok Gyu Kwon
RATIONALE: We report on a patient with hypersomnia who showed injury of the lower ascending reticular activating system (ARAS) following cerebellar herniation due to a cerebellar infarct, detected on diffusion tensor tractography (DTT). PATIENT CONCERNS: A 53-year-old male patient was diagnosed as a left cerebellar infarct, and underwent decompressive suboccipital craniectomy due to brain edema at 2 days after the onset of a cerebellar infarct. Three weeks after onset when the patient started rehabilitation, he showed hypersomnia without impairment of consciousness; he fell asleep most of daytime without external stimulation and showed an abnormal score on the Epworth Sleepiness Scale: 15 (full score: 24, cut off for hypersomnia: 10)...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28069320/mild-induced-hypothermia-for-patients-with-severe-traumatic-brain-injury-after-decompressive-craniectomy
#18
Chunhai Tang, Yun Bao, Min Qi, Lizhi Zhou, Fan Liu, Jian Mao, Qingmei Lei, Songtao Qi, Binghui Qiu
PURPOSE: To evaluate the efficacy and safety of mild induced hypothermia for intracranial hypertension in patients with traumatic brain injury after decompressive craniectomy. METHODS: A total of 60 adults with intracranial pressure (ICP) of more than 20 mm Hg after decompressive craniectomy were randomly assigned to standard care (control group) or hypothermia (32°C-35°C) plus standard care. Then, ICP, cerebral perfusion pressure, Glasgow Outcome Scale score, and complications were assessed...
December 29, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28066644/would-decompressive-craniectomy-really-bring-the-hope-to-severe-traumatic-brain-injury
#19
COMMENT
Hua-Wei Huang, Guo-Bin Zhang, Jian-Xin Zhou
No abstract text is available yet for this article.
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28059660/effects-of-decompressive-craniectomy-on-functional-outcomes-and-death-in-poor-grade-aneurysmal-subarachnoid-hemorrhage-a-systematic-review-and-meta-analysis
#20
Naif M Alotaibi, Ghassan Awad Elkarim, Nardin Samuel, Oliver G S Ayling, Daipayan Guha, Aria Fallah, Abdulrahman Aldakkan, Blessing N R Jaja, Airton Leonardo de Oliveira Manoel, George M Ibrahim, R Loch Macdonald
OBJECTIVE Patients with poor-grade aneurysmal subarachnoid hemorrhage (aSAH) (World Federation of Neurosurgical Societies Grade IV or V) are often considered for decompressive craniectomy (DC) as a rescue therapy for refractory intracranial hypertension. The authors performed a systematic review and meta-analysis to assess the impact of DC on functional outcome and death in patients after poor-grade aSAH. METHODS A systematic review and meta-analysis were performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
January 6, 2017: Journal of Neurosurgery
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