gms | German Medical Science

62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

07. - 11. Mai 2011, Hamburg

Timing of cranioplasty after decompressive craniectomy regarding postoperative complications

Meeting Abstract

  • P. Schuss - Klinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität Frankfurt am Main, Frankfurt/Main
  • E. Güresir - Klinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität Frankfurt am Main, Frankfurt/Main
  • L. Imöhl - Klinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität Frankfurt am Main, Frankfurt/Main
  • C.T. Ulrich - Klinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität Frankfurt am Main, Frankfurt/Main
  • H. Vatter - Klinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität Frankfurt am Main, Frankfurt/Main
  • V. Seifert - Klinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität Frankfurt am Main, Frankfurt/Main

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocDI.05.06

DOI: 10.3205/11dgnc131, URN: urn:nbn:de:0183-11dgnc1319

Veröffentlicht: 28. April 2011

© 2011 Schuss et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Decompressive craniectomy (DC) for intractable intracranial pressure mandates later cranioplasty (CP). Despite possible residual brain swelling after DC, several previous reports suggested an early performed CP in order to achieve a better neurological outcome. However, the timing of CP after DC remains still controversial. We therefore analyzed our prospectively conducted database concerning timing of CP and associated postoperative complications.

Methods: From October 1999 to January 2010, cranioplasty was performed 212 times at the authors' institution. Patients were divided into two groups according to the time to cranioplasty (≤ 2 months versus > 2 months). Patient characteristics, timing of CP and CP-related postoperative complications were analyzed.

Results: Overall CP was performed early in 22% vs. late in 78%. Complications after CP included wound healing disturbance (6.1%), EDH or SDH (4.2%), abscess (1.9%), hygroma (1.4%), CSF fistula (0.9%), and other (0.9%). The overall complication rate was 15.6%. Patients with VP shunt had a significant higher rate of complications after CP compared to patients without VP shunt (p=0.004). Patients, who underwent CP early after DC, suffered significantly more often from complications compared to patients, who underwent CP late after initial DC (25.5% vs. 12.7%; p=0.04). On multivariate analysis, early CP, presence of VP shunt and ICH as underlying pathology were significant predictors of postoperative complications after CP.

Conclusions: We provide detailed data on surgical timing and complication for cranioplasty after DC. The present data suggest that patients with CP performed more than 2 months after DC might benefit from a lower complication rate.