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Routine early CT scanning after craniotomy: is it effective for the early detection of postoperative intracranial hematoma?

  • Clinical Article - Neurosurgical Techniques
  • Published:
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Abstract

Background

Postoperative intracranial hematoma (POIH) is a frequent sequela secondary to cranial surgery. The role of routine early postoperative computed tomography (CT) scanning in the detection of POIH remains controversial. The study was aimed at analyzing the effect of routine early CT scanning after craniotomy for the early detection of POIH.

Methods

Routine early postoperative CT scanning was performed at our institute, and a retrospective study was conducted to analyze the data. POIH was defined as an intracranial hematoma requiring surgical management.

Results

A total of 1,148 patients undergoing craniotomy were included in this study; 28 of these patients developed POIH. The majority of POIH cases (15/28, 54 %) were detected during the first 6 h following craniotomy. A routine CT scan was performed on all included patients but two; however, CT scans detected only 16 POIH cases. During the first 6 h, the rate at which CT scans detected POIH was 1.9 % (15/786); subsequently, the rate decreased to only 0.3 % (1/360; p < 0.05, compared with the rate during the first 6 h). Among patients without clinical manifestations, the rate at which the routine post-craniotomy CT scan detected POIH was only 0.7 % (5/721) (p < 0.05, compared with the incidence of POIH). Finally, among high-risk POIH patients, the POIH-positive rate of routine CT scanning was elevated.

Conclusions

It appears that routine early CT scan is ineffective for the detection of POIH in patients undergoing craniotomy. However, if the strategy for routine scanning can be improved, its effect may be beneficial.

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    Authors and Affiliations

    1. Department of Neurosurgery, First Affiliated Hospital, College of Medicine, Zhejiang University, No.79 Qingchun Road, Hangzhou City, 310003, Zhejiang Province, People’s Republic of China

      Liang Wen, Xiao-Feng Yang, Hao Jiang, Hao Wang & Ren-Ya Zhan

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    1. Liang Wen
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    2. Xiao-Feng Yang
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    3. Hao Jiang
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    4. Hao Wang
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    Correspondence to Liang Wen.

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    The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

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    No funding was received for this research.

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    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 or beliefs) in the subject matter or materials discussed in this manuscript.

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    Liang Wen and Xiao-Feng Yang contributed equally to this work

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    Wen, L., Yang, XF., Jiang, H. et al. Routine early CT scanning after craniotomy: is it effective for the early detection of postoperative intracranial hematoma?. Acta Neurochir 158, 1447–1452 (2016). https://doi.org/10.1007/s00701-016-2883-4

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    • DOI: https://doi.org/10.1007/s00701-016-2883-4

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