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Early cranioplasty associated with a lower rate of post-traumatic hydrocephalus after decompressive craniectomy for traumatic brain injury

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Background

Post-traumatic hydrocephalus (PTH) is one of the primary complications during the course of traumatic brain injury (TBI). The aim of this study was to define factors associated with the development of PTH in patients who underwent unilateral decompressive craniectomy (DC) for TBI.

Methods

A total of 126 patients, who met the inclusion criteria of the study, were divided into two groups: patients with PTH (n = 25) and patients without PTH (n = 101). Their demographic, clinical, radiological, operative, and postoperative factors, which may be associated with the development of PTH, were compared.

Results

Multivariate logistic regression analysis revealed that cranioplasty performed later than 2 months following DC was significantly associated with the requirement for ventriculoperitoneal shunting due to PTH (p < 0.001). Also, a significant unfavorable outcome rate was observed in patients with PTH at 1-year follow-up according to the Glasgow Outcome Scale-Extended (p = 0.047).

Conclusions

Our results show that early cranioplasty within 2 months after DC was associated with a lower rate of PTH development after TBI.

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Abbreviations

PTH:

Post-traumatic hydrocephalus

TBI:

Traumatic brain injury

DC:

Decompressive craniectomy

VPS:

Ventriculoperitoneal shunting

GCS:

Glasgow Coma Score

GOS-E:

Glasgow Outcome Scale-Extended

SAH:

Subarachnoid hemorrhage

ROC:

Receiver-operating characteristic

AUC:

Area under the curve

CSF:

Cerebrospinal fluid

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Acknowledgements

The language editing of this article is partly supported by the Turkish Neurosurgical Society.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Department of Neurosurgery, School of Medicine, Bahcesehir University, Istanbul, Turkey

    Baris Ozoner

  2. Department of Neurosurgery, Sisli Hamidiye Etfal Research and Education Hospital, University of Medical Sciences, Istanbul, Turkey

    Mustafa Kilic, Levent Aydin, Ahmet Murat Musluman & Adem Yilmaz

  3. Department of Neurosurgery, Okmeydani Research and Education Hospital, University of Medical Sciences, Istanbul, Turkey

    Seckin Aydin

  4. Department of Biostatistics, School of Medicine, Erzincan Binali Yildirim University, Erzincan, Turkey

    Yusuf Kemal Arslan

  5. School of Medicine, Department of Neurosurgery, Erzincan Binali Yildirim University, Erzincan, Turkey

    Baris Ozoner

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  1. Baris Ozoner
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Correspondence to Baris Ozoner.

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Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge, and beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

This study was reviewed and approved by the Erzincan Binali Yildirim University Clinical Research Ethics Committee (Number: 33216249-604.01.02-E.53219). All procedures were performed in accordance with the ethical standards of the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all participants included in the study.

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Ozoner, B., Kilic, M., Aydin, L. et al. Early cranioplasty associated with a lower rate of post-traumatic hydrocephalus after decompressive craniectomy for traumatic brain injury. Eur J Trauma Emerg Surg 46, 919–926 (2020). https://doi.org/10.1007/s00068-020-01409-x

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  • DOI: https://doi.org/10.1007/s00068-020-01409-x

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