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Factors Associated Postoperative Hydrocephalus in Patients with Traumatic Acute Subdural Hemorrhage
Journal of Korean Neurosurgical Society ; : 730-737, 2017.
Artículo en Inglés | WPRIM | ID: wpr-64796
ABSTRACT

OBJECTIVE:

Postoperative hydrocephalus is a common complication following craniectomy in patients with traumatic brain injury, and affects patients’ long-term outcomes. This study aimed to verify the risk factors associated with the development of hydrocephalus after craniectomy in patients with acute traumatic subdural hemorrhage (tSDH).

METHODS:

Patients with acute traumatic SDH who had received a craniectomy between December 2005 and January 2016 were retrospectively assessed by reviewing the coexistence of other types of hemorrahges, measurable variables on computed tomography (CT) scans, and the development of hydrocephalus during the follow-up period.

RESULTS:

Data from a total of 63 patients who underwent unilateral craniectomy were analyzed. Postoperative hydrocephalus was identified in 34 patients (54%) via brain CT scans. Preoperative intraventricular hemorrhage (IVH) was associated with the development of hydrocephalus. Furthermore, the thickness of SDH (p=0.006) and the extent of midline shift before craniectomy (p=0.001) were significantly larger in patients with postoperative hydrocephalus. Indeed, multivariate analyses showed that the thickness of SDH (p=0.019), the extent of midline shift (p<0.001) and the coexistence of IVH (p=0.012) were significant risk factors for the development of postoperative hydrocephalus. However, the distance from the midline to the craniectomy margin was not an associated risk factor for postoperative hydrocephalus.

CONCLUSION:

In patients with acute traumatic SDH with coexisting IVH, a large amount of SDH, and a larger midline shift, close follow-up is necessary for the early prediction of postoperative hydrocephalus. Furthermore, craniectomy margin need not be limited in acute traumatic SDH patients for the reason of postoperative hydrocephalus.
Asunto(s)

Texto completo: Disponible Índice: WPRIM (Pacífico Occidental) Asunto principal: Encéfalo / Lesiones Encefálicas / Tomografía Computarizada por Rayos X / Análisis Multivariante / Estudios Retrospectivos / Factores de Riesgo / Estudios de Seguimiento / Hematoma / Hematoma Subdural / Hemorragia Tipo de estudio: Estudio de etiología / Estudio observacional / Estudio pronóstico / Factores de riesgo Límite: Humanos Idioma: Inglés Revista: Journal of Korean Neurosurgical Society Año: 2017 Tipo del documento: Artículo

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Texto completo: Disponible Índice: WPRIM (Pacífico Occidental) Asunto principal: Encéfalo / Lesiones Encefálicas / Tomografía Computarizada por Rayos X / Análisis Multivariante / Estudios Retrospectivos / Factores de Riesgo / Estudios de Seguimiento / Hematoma / Hematoma Subdural / Hemorragia Tipo de estudio: Estudio de etiología / Estudio observacional / Estudio pronóstico / Factores de riesgo Límite: Humanos Idioma: Inglés Revista: Journal of Korean Neurosurgical Society Año: 2017 Tipo del documento: Artículo