Changes of intracranial pressure, cerebral hemodynamic parameters and neuro-rehabilitation in adult patients after cranioplasty reconstruction with digital shaping titanium mesh
10.3760/cma.j.issn.1671-8925.2015.11.009
- VernacularTitle:数字化塑型钛网颅骨修补对颅骨缺损患者颅内压、脑血流动力学及神经功能康复的影响
- Author:
Sheng LUO
1
;
Yongsheng HE
;
Longyi CHEN
;
Guangfu HUANG
Author Information
1. 618400 什邡,川北医学院附属什邡医院,什邡市人民医院神经外科
- Keywords:
Skull defect;
Titanium mesh;
Cranioplasty;
Intracranial pressure;
Cerebral hemodynamics;
Nerve function
- From:
Chinese Journal of Neuromedicine
2015;14(11):1128-1132
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the appropriate time of the skull reconstruction of skull defect,and explore the changes of intracmnial pressure,cerebral hemodynamic parameters,clinical symptoms and signs before and after cranioplasty with digital shaping titanium mesh.Methods The clinical data included parameter variations of noninvasive intracranial pressure (ICP),cerebral blood flow velocity,and improvement of skull defect syndrome and cognitive function were retrospectivly analyzed in 69 patients with skull defect received cranioplasty with digital shaping titanium mesh in our hospital from June 2009 to May 2014.The preoperative ICP less than 80 mmH2O was recorded in 53 patients and that more than or equal to 80 mmH2O was recorded in 16 patients.The interval time from the skull defects to cranioplasty was as follows:11 patients were within 3-6 months,25 were in 6-9 months,24 were in 9-12 months,and 9 were more than one year.Results The ICP after cranioplasty was in the normal range,which was statistically different as compared with that before cranioplasty (P＜0.05).The mean blood flow velocity two weeks after cranioplasty was improved significantly as compared with that before cranioplasty (P＜0.05).All 69 patients were recovered well postoperatively;14 patients with preoperative sensory and movement disorders got improvement of different degrees after cranioplasty;in the four patients with epilepsy,three were seizure-free,and the left one had obviously reduced epileptic seizure;two patients with speech disorders got improvement postoperatively.Skull defect syndrome symptoms in the 54 patients were disappeared.Significant differences of Glasgow outcome scale (GOS) and function independent measurement (FIM) scores were noted between before cranioplasty and three months after cranioplasty (2.48±0.67 vs.3.56±0.35;77.91±10.32 vs.93.78±6.51;P＜0.05).The GOS and FIM scores in patients performed cranioplasty at early stage (interval time from the skull defects to cranioplasty within 12 months) were significantly improved as compared with those before cranioplasty (P＜0.05).Conclusion The digital shaping titanium mesh skull reconstruction of skull defect could stabilize the ICP,and improve the dynamic state of pathological cerebral blood flow and cognition impairment,and is conducive to the recovery of nervous function;and early cranioplasty can have a good prognosis.
