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

Detalhes bibliográficos
Autor(a) principal: Silva Neto, Angelo R.
Data de Publicação: 2019
Outros Autores: Valença, Marcelo M.
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Institucional da UFRN
DOI: 10.1016/j.clineuro.2019.05.003
Texto Completo: https://repositorio.ufrn.br/handle/123456789/52411
Resumo: 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.
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spelling Silva Neto, Angelo R.Valença, Marcelo M.0000-0002-3819-89512023-05-15T22:00:15Z2023-05-15T22:00:15Z2019-07SILVA 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/123456789/5241110.1016/j.clineuro.2019.05.003Clinical Neurology and Neurosurgeryhttps://creativecommons.org/licenses/by-nc-nd/4.0/deed.pt_BRinfo:eu-repo/semantics/openAccessdecompressive craniectomyhydrocephalusposttraumatic hydrocephalustraumatic brain injuryTranscalvarial brain herniation volume as a predictor of posttraumatic hydrocephalus after decompressive craniectomyinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleObjectives: 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.porreponame:Repositório Institucional da UFRNinstname:Universidade Federal do Rio Grande do Norte (UFRN)instacron:UFRNLICENSElicense.txtlicense.txttext/plain; charset=utf-81484https://repositorio.ufrn.br/bitstream/123456789/52411/2/license.txte9597aa2854d128fd968be5edc8a28d9MD52ORIGINALTranscalvarialBrainHerniation_SilvaNeto_2019.pdfTranscalvarialBrainHerniation_SilvaNeto_2019.pdfapplication/pdf1077514https://repositorio.ufrn.br/bitstream/123456789/52411/1/TranscalvarialBrainHerniation_SilvaNeto_2019.pdf9556f2d7fa2fdb6d014912f45de7f98fMD51123456789/524112023-07-04 13:46:05.883oai:https://repositorio.ufrn.br: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Repositório de PublicaçõesPUBhttp://repositorio.ufrn.br/oai/opendoar:2023-07-04T16:46:05Repositório Institucional da UFRN - Universidade Federal do Rio Grande do Norte (UFRN)false
dc.title.pt_BR.fl_str_mv Transcalvarial brain herniation volume as a predictor of posttraumatic hydrocephalus after decompressive craniectomy
title Transcalvarial brain herniation volume as a predictor of posttraumatic hydrocephalus after decompressive craniectomy
spellingShingle Transcalvarial brain herniation volume as a predictor of posttraumatic hydrocephalus after decompressive craniectomy
Silva Neto, Angelo R.
decompressive craniectomy
hydrocephalus
posttraumatic hydrocephalus
traumatic brain injury
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
author Silva Neto, Angelo R.
author_facet Silva Neto, Angelo R.
Valença, Marcelo M.
author_role author
author2 Valença, Marcelo M.
author2_role author
dc.contributor.authorID.pt_BR.fl_str_mv 0000-0002-3819-8951
dc.contributor.author.fl_str_mv Silva Neto, Angelo R.
Valença, Marcelo M.
dc.subject.por.fl_str_mv decompressive craniectomy
hydrocephalus
posttraumatic hydrocephalus
traumatic brain injury
topic decompressive craniectomy
hydrocephalus
posttraumatic hydrocephalus
traumatic brain injury
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.
publishDate 2019
dc.date.issued.fl_str_mv 2019-07
dc.date.accessioned.fl_str_mv 2023-05-15T22:00:15Z
dc.date.available.fl_str_mv 2023-05-15T22:00:15Z
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dc.identifier.citation.fl_str_mv 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.
dc.identifier.uri.fl_str_mv https://repositorio.ufrn.br/handle/123456789/52411
dc.identifier.doi.none.fl_str_mv 10.1016/j.clineuro.2019.05.003
identifier_str_mv 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.
10.1016/j.clineuro.2019.05.003
url https://repositorio.ufrn.br/handle/123456789/52411
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dc.publisher.none.fl_str_mv Clinical Neurology and Neurosurgery
publisher.none.fl_str_mv Clinical Neurology and Neurosurgery
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