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Effects of Cranioplasty After Decompressive Craniectomy on Neurological Function and Cerebral Hemodynamics in Traumatic Versus Nontraumatic Brain Injury

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Intracranial Pressure and Neuromonitoring XVII

Part of the book series: Acta Neurochirurgica Supplement ((NEUROCHIRURGICA,volume 131))

Summary

After decompressive craniectomy (DC), cranioplasty (CP) can help to normalize vascular and cerebrospinal fluid circulation besides improving the patient’s neurological status. The aim of this study was to investigate the effects of CP on cerebral hemodynamics and on cognitive and functional outcomes in patients with and without a traumatic brain injury (TBI). Over a period of 3 years, 51 patients were included in the study: 37 TBI patients and 14 non-TBI patients. The TBI group was younger (28.86 ± 9.71 versus 45.64 ± 9.55 years, P = 0.0001), with a greater proportion of men than the non-TBI group (31 versus 6, P = 0.011). Both groups had improved cognitive outcomes (as assessed by the Mini–Mental State Examination) and functional outcomes (as assessed by the Barthel Index and Modified Rankin Scale) 90 days after CP. In the TBI group, the mean velocity of blood flow in the middle cerebral artery ipsilateral to the cranial defect increased between the time point before CP and 90 days after CP (34.24 ± 11.02 versus 42.14 ± 10.19 cm/s, P = 0.0001). In conclusion, CP improved the neurological status in TBI and non-TBI patients, but an increment in cerebral blood flow velocity after CP occurred only in TBI patients.

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Author information

Authors and Affiliations

  1. Graduate Program in Medical Science, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil

    Carla B. Rynkowski & Marino Muxfeldt Bianchin

  2. Adult Critical Care Unit, Hospital Cristo Redentor, Porto Alegre, Brazil

    Carla B. Rynkowski

  3. Department of Anaesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology, Genoa, Italy

    Chiara Robba

  4. Adult Critical Care Unit, Hospital Divina Providência, Porto Alegre, Brazil

    Melina Loreto

  5. Graduate Program, Medical School, Universidade Luterana do Brasil, Canoas, Brazil

    Ana Carolina Wickert Theisen

  6. Neurosurgical Division, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK

    Angelos G. Kolias & Marek Czosnyka

  7. NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK

    Angelos G. Kolias

  8. Department of Neurosurgery, Hospital Cristo Redentor, Porto Alegre, Brazil

    Guilherme Finger

  9. B.R.A.I.N., Division of Neurology, Hospital de Clínicas de Poro Alegre, Porto Alegre, Brazil

    Marino Muxfeldt Bianchin

Authors
  1. Carla B. Rynkowski
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  2. Chiara Robba
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  4. Ana Carolina Wickert Theisen
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  6. Guilherme Finger
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  7. Marek Czosnyka
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Editor information

Editors and Affiliations

  1. Department of Neurosurgery, University Hospitals Leuven, Leuven, Belgium

    Bart Depreitere

  2. Department of Intensive Care Medicine, University Hospitals Leuven, Leuven, Belgium

    Geert Meyfroidt

  3. Department of Intensive Care Medicine, University Hospitals Leuven, Leuven, Belgium

    Fabian Güiza

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Rynkowski, C.B. et al. (2021). Effects of Cranioplasty After Decompressive Craniectomy on Neurological Function and Cerebral Hemodynamics in Traumatic Versus Nontraumatic Brain Injury. In: Depreitere, B., Meyfroidt, G., Güiza, F. (eds) Intracranial Pressure and Neuromonitoring XVII. Acta Neurochirurgica Supplement, vol 131. Springer, Cham. https://doi.org/10.1007/978-3-030-59436-7_17

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  • DOI: https://doi.org/10.1007/978-3-030-59436-7_17

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-59435-0

  • Online ISBN: 978-3-030-59436-7

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