Document Detail

Extensive duraplasty with autologous graft in decompressive craniectomy and subsequent early cranioplasty for severe head trauma.
MedLine Citation:
PMID:  20880449     Owner:  NLM     Status:  In-Process    
OBJECTIVE: To compare the effect of extensive duraplasty and subsequent early cranioplasty on the recovery of neurological function in management of patients with severe traumatic brain injuries received decompressive craniectomy.
METHODS: The computer-aided designation of titanium armor plate was used as a substitute for the repair of skull defect in all the patients. The patients were divided into three groups. Twenty-three patients were in early cranioplasty group who received extensive duraplasty in craniectomy and subsequent cranioplasty within 3 months after previous operation (Group I). Twenty-one patients whose cranioplasty was performed more than 3 months after the first operation were in the group without duraplasty (Group II); while the other 26 patients in the group with duraplasty in previous craniotomy (Group III). Both the Barthel index of activity of daily living (ADL) 3 months after craniotomy for brain injuries and 1 month after cranioplasty and Karnofsky Performance Score (KPS) at least 6 months after cranioplasty were assessed respectively.
RESULTS: The occurrence of adverse events commonly seen in cranioplasty, such as incision healing disturbance, fluid collection below skin flap, infection and onset of postoperative epilepsy was not significantly higher than other 2 groups. The ADL scores at 3 months after craniotomy in Groups I-III were 58.9 ± 26.7, 40.8 ± 20.2 and 49.2 ± 18.6. The ADL scores at 1 month after cranioplasty were 70.2 ± 25.2, 50.8 ± 24.8 and 61.2 ± 21.5. The forward KPS scores were 75.4 ± 19.0, 66.5 ± 24.7 and 57.6 ± 24.7 respectively. The ADL and KPS socres were significantly higher in group I than other 2 groups.
CONCLUSION: The early cranioplasty in those with extensive duraplasty in previous craniotomy is feasible and helpful to improving ADL and long-term quality of life in patients with severe traumatic brain injuries.
Guo-liang Zhang; Wei-zhong Yang; Yan-wei Jiang; Tao Zeng
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chinese journal of traumatology = Zhonghua chuang shang za zhi / Chinese Medical Association     Volume:  13     ISSN:  1008-1275     ISO Abbreviation:  Chin. J. Traumatol.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100886162     Medline TA:  Chin J Traumatol     Country:  China    
Other Details:
Languages:  eng     Pagination:  259-64     Citation Subset:  IM    
Neurosurgery Department, Affiliated Union Hospital, Fujian Medical University, Fuzhou 350001, China.
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