Abstract:
BACKGROUND:Decompressive craniectomy procedures are performed in patients with malignant intracranial hypertension. A bone flap is removed to relieve pressure. Later, a second operation is performed to reconstruct the skull after brain swelling has resolved. This surgical treatment would be improved if it were possible to perform a single operation that decompressed the brain acutely and eliminated the need for a second operation. To design a device and procedure that achieve this objective, it is essential to understand how the brain swells after a craniectomy procedure. METHODS:We identified 20 patients with ischemic stroke who underwent a decompressive hemicraniectomy operation. Skull defect morphology and postoperative brain swelling were measured using computed tomography scan data. Additional intracranial volume created by placing a hypothetical cranial plate implant offset from the skull surface by 5 mm was measured for each patient. RESULTS:The average craniectomy area and brain herniation volume was 9999 ± 1283 mm2 and 30.48 ± 23.56 mL, respectively. In all patients, the additional volume created by this hypothetical implant exceeded the volume of brain herniation observed. CONCLUSIONS:These findings show that a cranial plate with a 5-mm offset accommodates the brain swelling that occurs in this patient population.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Stoner KE,Abode-Iyamah KO,Grosland NM,Howard MA 3rddoi
10.1016/j.wneu.2016.08.095subject
Has Abstractpub_date
2016-12-01 00:00:00pages
101-106eissn
1878-8750issn
1878-8769pii
S1878-8750(16)30779-3journal_volume
96pub_type
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journal_title:World neurosurgery
pub_type: 杂志文章
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journal_title:World neurosurgery
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journal_title:World neurosurgery
pub_type: 杂志文章
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journal_title:World neurosurgery
pub_type: 杂志文章
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journal_title:World neurosurgery
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pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章,meta分析,评审
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pub_type: 杂志文章
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journal_title:World neurosurgery
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更新日期:2020-09-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.wneu.2016.12.042
更新日期:2017-03-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章,评审
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pub_type: 杂志文章
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更新日期:2020-03-01 00:00:00
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更新日期:2018-01-01 00:00:00
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更新日期:2018-06-01 00:00:00
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更新日期:2019-10-01 00:00:00
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pub_type: 杂志文章,meta分析,评审
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更新日期:2016-03-01 00:00:00
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更新日期:2019-06-01 00:00:00
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更新日期:2018-11-01 00:00:00
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