Transcalvarial brain herniation volume as a predictor of posttraumatic hydrocephalus after decompressive craniectomy

Objectives: In patients undergoing decompressive craniectomy for traumatic brain injury(TBI) there has been reported an incidence of hydrocephalus between 0–45%. There are several radiological and clinical features described in association with development of hydrocephalus. For study the influence o...

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Principais autores: Silva Neto, Angelo R., Valença, Marcelo M.
Outros Autores: 0000-0002-3819-8951
Formato: article
Idioma:pt_BR
Publicado em: Clinical Neurology and Neurosurgery
Assuntos:
decompressive craniectomy
hydrocephalus
posttraumatic hydrocephalus
traumatic brain injury
Endereço do item:https://repositorio.ufrn.br/handle/123456789/52411
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spelling ri-123456789-524112023-07-04T16:46:05Z Transcalvarial brain herniation volume as a predictor of posttraumatic hydrocephalus after decompressive craniectomy Silva Neto, Angelo R. Valença, Marcelo M. 0000-0002-3819-8951 decompressive craniectomy hydrocephalus posttraumatic hydrocephalus traumatic brain injury Objectives: In patients undergoing decompressive craniectomy for traumatic brain injury(TBI) there has been reported an incidence of hydrocephalus between 0–45%. There are several radiological and clinical features described in association with development of hydrocephalus. For study the influence of these factors we con ducted a retrospective observational single-center cohort study in a tertiary care center with special attention to the transcalvarial herniation(TCH) volume after decompressive craniectomy. Patients and methods: We selected 50 patients that underwent decompressive craniectomy after closed head injury between january 2014 and January 2015. Hydrocephalus was defined as a modified frontal horn index greater than 33%, presence of Gudeman CT scan criteria or insertion of ventriculoperitoneal Shunt. Variables analyzed were: age, post-resuscitation Glasgow coma scale (GCS) score, pupil reactivity, Zunkeller index, pre sence of hygroma, TCH volume, craniectomy diameter and distance of craniectomy from midline. Logistic re gression was used with hydrocephalus as the primary outcome measure. Results: 17 patients developed hydrocephalus (34%). TCH volume after decompression(p < 0.01), subdural hygroma (p < 0.01), lower admission Glasgow Coma Scale score (p = 0.015), unilateral pupil reactivity (p = 0.042) and higher Zumkeller index(p = 0.044) were significant risk factors for hydrocephalus. Logistic regression analysis showed that factors independently associated with the development of hydrocephalus was the TCH volume (odds ratio 11.08; 95%CI 2.10, 58.4; p = 0.0046), and presence of hygroma (odds ratio 49.59; 95%IC 4.1, 459; p = 0.002). Conclusions: There was a clear association between severity of TBI, TCH volume and subdural hygroma with the development of hydrocephalus. Clinicians should follow closely patients with those findings in order to avoid late deterioration. 2023-05-15T22:00:15Z 2023-05-15T22:00:15Z 2019-07 article SILVA NETO, Angelo R.; VALENÇA, Marcelo M.. Transcalvarial brain herniation volume as a predictor of posttraumatic hydrocephalus after decompressive craniectomy. Clinical Neurology And Neurosurgery, [S.L.], v. 182, p. 73-78, jul. 2019. Elsevier BV. http://dx.doi.org/10.1016/j.clineuro.2019.05.003. https://repositorio.ufrn.br/handle/123456789/52411 10.1016/j.clineuro.2019.05.003 pt_BR https://creativecommons.org/licenses/by-nc-nd/4.0/deed.pt_BR application/pdf Clinical Neurology and Neurosurgery
institution Repositório Institucional
collection RI - UFRN
language pt_BR
topic decompressive craniectomy
hydrocephalus
posttraumatic hydrocephalus
traumatic brain injury
spellingShingle decompressive craniectomy
hydrocephalus
posttraumatic hydrocephalus
traumatic brain injury
Silva Neto, Angelo R.
Valença, Marcelo M.
Transcalvarial brain herniation volume as a predictor of posttraumatic hydrocephalus after decompressive craniectomy
description Objectives: In patients undergoing decompressive craniectomy for traumatic brain injury(TBI) there has been reported an incidence of hydrocephalus between 0–45%. There are several radiological and clinical features described in association with development of hydrocephalus. For study the influence of these factors we con ducted a retrospective observational single-center cohort study in a tertiary care center with special attention to the transcalvarial herniation(TCH) volume after decompressive craniectomy. Patients and methods: We selected 50 patients that underwent decompressive craniectomy after closed head injury between january 2014 and January 2015. Hydrocephalus was defined as a modified frontal horn index greater than 33%, presence of Gudeman CT scan criteria or insertion of ventriculoperitoneal Shunt. Variables analyzed were: age, post-resuscitation Glasgow coma scale (GCS) score, pupil reactivity, Zunkeller index, pre sence of hygroma, TCH volume, craniectomy diameter and distance of craniectomy from midline. Logistic re gression was used with hydrocephalus as the primary outcome measure. Results: 17 patients developed hydrocephalus (34%). TCH volume after decompression(p < 0.01), subdural hygroma (p < 0.01), lower admission Glasgow Coma Scale score (p = 0.015), unilateral pupil reactivity (p = 0.042) and higher Zumkeller index(p = 0.044) were significant risk factors for hydrocephalus. Logistic regression analysis showed that factors independently associated with the development of hydrocephalus was the TCH volume (odds ratio 11.08; 95%CI 2.10, 58.4; p = 0.0046), and presence of hygroma (odds ratio 49.59; 95%IC 4.1, 459; p = 0.002). Conclusions: There was a clear association between severity of TBI, TCH volume and subdural hygroma with the development of hydrocephalus. Clinicians should follow closely patients with those findings in order to avoid late deterioration.
author2 0000-0002-3819-8951
author_facet 0000-0002-3819-8951
Silva Neto, Angelo R.
Valença, Marcelo M.
format article
author Silva Neto, Angelo R.
Valença, Marcelo M.
author_sort Silva Neto, Angelo R.
title Transcalvarial brain herniation volume as a predictor of posttraumatic hydrocephalus after decompressive craniectomy
title_short Transcalvarial brain herniation volume as a predictor of posttraumatic hydrocephalus after decompressive craniectomy
title_full Transcalvarial brain herniation volume as a predictor of posttraumatic hydrocephalus after decompressive craniectomy
title_fullStr Transcalvarial brain herniation volume as a predictor of posttraumatic hydrocephalus after decompressive craniectomy
title_full_unstemmed Transcalvarial brain herniation volume as a predictor of posttraumatic hydrocephalus after decompressive craniectomy
title_sort transcalvarial brain herniation volume as a predictor of posttraumatic hydrocephalus after decompressive craniectomy
publisher Clinical Neurology and Neurosurgery
publishDate 2023
url https://repositorio.ufrn.br/handle/123456789/52411
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AT valencamarcelom transcalvarialbrainherniationvolumeasapredictorofposttraumatichydrocephalusafterdecompressivecraniectomy
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