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  • The alteration of intracranial pressure and imaging features after decompressive craniectomy with lattice duraplasty

    Final Number:
    1444

    Authors:
    Dongxia Feng MD; John Diaz Day MD

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2012 Annual Meeting

    Introduction: To investigate the alteration of intracranial pressure and imaging features after decompressive craniectomy with lattice duraplasty in patients with severe head injury.

    Methods: Fifty patients suffered from severe head injury with brain swelling were operated using Amercian standard large trauma craniotomy, the lattice duraplasty technique was applied intraoperatively. The pre- and post-operative ICP and imaging features were observed and recorded, followed by a statistical comparative study.

    Results: The preoperative ICP was 37.6±7.9mmHg, the midline shift was 11.7±3.8mm, the patients with open ambient cistern were 3 cases. The postoperative ICP reduced to 14.1±6.3mmHg,the midline shift decreased to 4.6±2.7mm, and the patients with open ambient cistern were 31cases. Compared with preoperative data all postoperative data were improved significantly (P<0.01).

    Conclusions: The technique of lattice duraplasty used in decompressive craniectomy could reduce ICP and midline shift meanwhile alleviate the ambient cistern compression.

    Patient Care: This research has confirmed the clinical efficacy of decompressive craniectomy with lattice duraplasty for severe head injury.

    Learning Objectives: To understand the technique and clinical value of decompressive craniectomy with lattice duraplasty for severe head injury.

    References: 1.Alves OL, Bullock R. “Basal durotomy” to prevent massive intra-operative traumatic brain swelling[J]. Acta Neurochir(Wien), 2003, 145: 583-586. 2.Mitchell P, Tseng M, Mendelow AD: Decompressive craniectomy with lattice duraplasty[J].Acta Neurochir(Wien), 2004, 146: 159-160. 3.Thomas SS, Catherine ER, Christer J, et al. Aspects in decopressive craniectomy in patients with traumatic head injuries[J]. J Neurotrama, 2006, 23: 1502-1509. 4.Munch E, Horn P, Schurer L, et al. Management of severe traumatic brain injury by decopressive craniectomy[J]. Neurosurgery, 2000, 47: 315-323. 5.Bullock MR, Chesnut R, Ghajar J, et al. Guidelines for the surgical management of traumatic brain injury[J]. Neurosurgery, 2006, 58:s1-62.

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