| Decompressive craniectomy is not an independent risk factor for communicating hydrocephalus in patients with increased intracranial pressure. | |
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MedLine Citation:
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PMID: 20651634 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: It was recently suggested that communicating hydrocephalus is an almost universal finding after hemicraniectomy and that early cranioplasty may prevent the need for permanent cerebrospinal fluid diversion in these patients. OBJECTIVE: To conduct a study in an attempt to verify these findings. METHODS: The medical records of all patients who underwent decompressive craniectomy for medically refractory elevated intracranial pressure between 2001 and 2009 were retrospectively reviewed. Patients with subarachnoid hemorrhage, intraventricular hemorrhage, or head trauma were excluded. Hydrocephalus was classified as internal or external and as clinically significant or asymptomatic. RESULTS: The patient population consisted of 17 patients, 8 men and 9 women, with a median age of 44 years (range, 27-53 years). Etiologies included malignant middle cerebral artery territory infarction in 12 patients, hemorrhagic transformation of ischemic cerebrovascular accident in 2 patients, dural sinus thrombosis in 2 patients, and hemorrhagic cerebrovascular accident in 1 patient. The extent of craniectomy ranged from a large bone flap in 4 patients to a standard hemicraniectomy in 13 patients. Two patients died and 1 was lost to follow-up during the acute stage. The remaining 14 patients underwent cranioplasty after a median interval of 21 days (range, 3-42 days). In none of these patients did clinically significant hydrocephalus develop requiring cerebrospinal fluid diversion. Asymptomatic extra-axial cerebrospinal fluid collections developed in 2 patients that resolved spontaneously after cranioplasty. CONCLUSION: Our results suggest that, contrary to some beliefs, hydrocephalus does not frequently occur after decompressive craniectomy. |
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Authors:
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Ralph Rahme; Alexander G Weil; Mike Sabbagh; Robert Moumdjian; Alain Bouthillier; Michel W Bojanowski |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Neurosurgery Volume: 67 ISSN: 1524-4040 ISO Abbreviation: Neurosurgery Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-08-23 Completed Date: 2011-05-17 Revised Date: 2011-09-12 |
Medline Journal Info:
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Nlm Unique ID: 7802914 Medline TA: Neurosurgery Country: United States |
Other Details:
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Languages: eng Pagination: 675-8; discussion 678 Citation Subset: IM |
Affiliation:
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Division of Neurosurgery, Hôpital Notre-Dame du CHUM, University of Montreal, Montreal, Quebec, Canada. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Decompressive Craniectomy / adverse effects*, contraindications Female Humans Hydrocephalus / etiology*, physiopathology*, prevention & control Intracranial Hypertension / physiopathology*, surgery* Male Middle Aged Postoperative Complications / physiopathology*, prevention & control Retrospective Studies Risk Factors |
| Comments/Corrections | |
Comment In:
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Neurosurgery. 2011 May;68(5):E1509; author reply E1509-10
[PMID:
21311372
]
Neurosurgery. 2011 Jun;68(6):E1777-8; author reply E1778-9 [PMID: 21389892 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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