Clinical analysis of cranioplasty combined with shunt in the treatment of skull defect complicated with hydrocephalus after craniocerebral trauma / 中国神经精神疾病杂志

ABSTRACT

Objective To evaluate the clinical efficacy of ventricle -peritoneal or ventricle-atrial shunt in the treatment of skull defect with craniocerebral trauma combined with hydrocephalus in the same period. Methods Sixty-four patients with skull defect after craniocerebral trauma combined with hydrocephalus were randomly divided into observation group (n=32) and control group (n=32) The ventricle-peritoneal or ventricle-atrial shunt and skull repair were conducted simultaneously following surgical operation in observation group whereas ventricle-peritoneal or ventricle-atrial shunt and the skull defect were performed within 3 months and after 3 months following operation, respectively. The hydrocephalus symptoms, prognosis after three months ,clinical outcomes and the postoperative complications were evaluated. Results There was no significant difference in hydrocephalus symptoms between the observation group and control group (χ2=0.005,P>0.05). The GCS score, GOS score and neurological function score after three months were better than those before the treatment in these two groups (P<0.05). These functional parameters were significantly better in the observation group than in control group (P<0.05). The good rate in three months was significantly higher in the observation group than in control group (59.38％vs 31.25％,χ2=7.23, P<0.05). The incidence of complication was 6.25％(2/32) in the observation group, which was significantly lower than that in the control group (31.25％, 10/32) (χ2=7.13, P<0.05).Conclusion Cranioplasty combined with shunt in the treatment of skull defect complicated with craniocerebral trauma-associated hydrocephalus has low postoperative complications, good clinical prognosis and reliable efficacy, which is worthy of clinical application.