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70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

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Is routine postoperative head CT necessary aftermicrovascular decompression?

Ist die routinemäßige postoperative craniale CT-Kontrolle nach mikrovaskulärer Dekompression notwendig?

Meeting Abstract

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  • presenting/speaker Gökce Hatipoglu Majernik - Medizinische Hochschule Hannover, Klinik für Neurochirurgie, Hannover, Deutschland
  • Shadi Al-Afif - Medizinische Hochschule Hannover, Klinik für Neurochirurgie, Hannover, Deutschland
  • Hans E. Heissler - Medizinische Hochschule Hannover, Klinik für Neurochirurgie, Hannover, Deutschland
  • Luisa Cassini Ascencao - Medizinische Hochschule Hannover, Klinik für Neurochirurgie, Hannover, Deutschland
  • Joachim K. Krauss - Medizinische Hochschule Hannover, Klinik für Neurochirurgie, Hannover, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocP138

doi: 10.3205/19dgnc474, urn:nbn:de:0183-19dgnc4740

Published: May 8, 2019

© 2019 Hatipoglu Majernik et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: Postoperative head CT scanning is routinely performed worldwide for detection of complications following intracranial procedures. However, it remains unclear whether with regard to costs and possibly missing consequences this is truly necessary in various operative procedures. The objective of this study was to analyze whether routine postoperative CT scans after microvascular decompression are necessary or whether they may be abandoned.

Methods: A series of 205 patients undergoing microvascular decompression (MVD) for trigeminal neuralgia (TN), hemifacial spasm (HFS), vagoglossopharyngeal neuralgia (VGPN) and vertigo operated by the senior surgeon in prone position were included in this study. All postoperative head CT scans were performed within 24 hours.

Results: CT detected small circumscribed postoperative hemorrhage in 9/205 (4,3%) instances. Hemorrhage was localized at the site of the Teflon felt (4/9), in the subdural space (3/9), the subarachnoid space (1/9) and in the ventricle (1/9). MVD had been performed for TN in 6/9 patients, HFS in 2/9 and both TN and HFS in 1/9. No patient underwent a second operation. Hemorrhage was symptomatic in three instances: mild postoperative gait ataxia (1), delayed facial palsy (1) and facial palsy, ptosis and hearing loss (1). The two patients with facial palsy were treated with corticosteroids. At 3-month follow-up they had no neurological deficits.

Conclusion: Postoperative routine CT controls are not necessary after MVD in patients who do not have postoperative neurological deficits when operated by experienced hands in the prone position.