TY  - JOUR
PY  - 2018//
TI  - Cranioplasty after severe traumatic brain injury: effects of trauma and patient recovery on cranioplasty outcome
JO  - Frontiers in neurology
A1  - Posti, Jussi P.
A1  - Yli-Olli, Matias
A1  - Heiskanen, Lauri
A1  - Aitasalo, Kalle M. J.
A1  - Rinne, Jaakko
A1  - Vuorinen, Ville
A1  - Serlo, Willy
A1  - Tenovuo, Olli
A1  - Vallittu, Pekka K.
A1  - Piitulainen, Jaakko M.
SP  - e223
EP  - e223
VL  - 9
IS  - 
N2  - BACKGROUND: In patients with severe traumatic brain injury (sTBI) treated with decompressive craniectomy (DC), factors affecting the success of later cranioplasty are poorly known. <br><br>OBJECTIVE: We sought to investigate if injury- and treatment-related factors, and state of recovery could predict the risk of major complications in cranioplasty requiring implant removal, and how these complications affect the outcome. <br><br>METHODS: A retrospective cohort of 40 patients with DC following sTBI and subsequent cranioplasty was studied. Non-injury-related factors were compared with a reference population of 115 patients with DC due to other conditions. <br><br>RESULTS: Outcome assessed 1 day before cranioplasty did not predict major complications leading to implant removal. Successful cranioplasty was associated with better outcome, whereas a major complication attenuates patient recovery: in patients with favorable outcome assessed 1 year after cranioplasty, major complication rate was 7%, while in patients with unfavorable outcome the rate was 42% (<i>p</i> = 0.003). Of patients with traumatic subarachnoid hemorrhage (tSAH) on admission imaging 30% developed a major complication, while none of patients without tSAH had a major complication (<i>p</i> = 0.014). Other imaging findings, age, admission Glasgow Coma Scale, extracranial injuries, length of stay at intensive care unit, cranioplasty materials, and timing of cranioplasty were not associated with major complications. <br><br>CONCLUSION: A successful cranioplasty after sTBI and DC predicts favorable outcome 1 year after cranioplasty, while stage of recovery before cranioplasty does not predict cranioplasty success or failure. tSAH on admission imaging is a major risk factor for a major complication leading to implant removal.<p />  <p>Language: en</p>
LA  - en
SN  - 1664-2295
UR  - http://dx.doi.org/10.3389/fneur.2018.00223
ID  - ref1
ER  -