Dynamic Decompressive Craniotomy with a Novel Reversibly Expandable Plate

Rohit Khanna

doi:10.1055/s-0036-1594013

Journal of Neurological Surgery Part A: Central European Neurosurgery, Inhaltsverzeichnis

J Neurol Surg A Cent Eur Neurosurg 2017; 78(04): 386-389
DOI: 10.1055/s-0036-1594013

Technical Note

Georg Thieme Verlag KG Stuttgart · New York

Dynamic Decompressive Craniotomy with a Novel Reversibly Expandable Plate

Autoren

Rohit Khanna

¹Department of Neurosurgery, Halifax Health, Daytona Beach, Florida, United States

²Department of Neurosurgery, Florida State University College of Medicine, Daytona Beach, Florida, United States

Abstract

Objective To assess the feasibility of a dynamic craniotomy procedure with the use of a novel reversibly expandable cranial bone flap fixation plate. The expandable plate allows outward bone flap migration with an increase in intracranial volume or intracranial pressure (ICP).

Methods Dynamic craniotomy intracranial hypertension compliance was evaluated in a skull model with progressive increase in intracranial volume and compared with the standard craniotomy with fixed plates.

Results Dynamic craniotomy provided significant control of ICP with increasing intracranial volume compared with the standard craniotomy. With an incremental increase in intracranial volume from 360 mL to 600 mL, the ICP increased from 2.6 to 91.9 mm Hg with the standard craniotomy, whereas with the dynamic craniotomy the ICP for similar intracranial volume increased from 2.5 to 25 mm Hg (p < 0.00001).

Conclusions The dynamic craniotomy procedure provides superior control of ICP with an abrupt intracranial volume increase when compared with the standard craniotomy.

Keywords

brain swelling - cerebral edema - cranial fixation - plate - craniectomy - cranioplasty - decompressive craniotomy - intracranial hypertension - malignant stroke - traumatic brain injury

Volltext

Referenzen

References
1 Aarabi B, Hesdorffer DC, Ahn ES, Aresco C, Scalea TM, Eisenberg HM. Outcome following decompressive craniectomy for malignant swelling due to severe head injury. J Neurosurg 2006; 104 (04) 469-479
2 Bor-Seng-Shu E, Figueiredo EG, Amorim RLO. , et al. Decompressive craniectomy: a meta-analysis of influences on intracranial pressure and cerebral perfusion pressure in the treatment of traumatic brain injury. J Neurosurg 2012; 117 (03) 589-596
3 Burger R, Duncker D, Uzma N, Rohde V. Decompressive craniotomy: durotomy instead of duroplasty to reduce prolonged ICP elevation. Acta Neurochir Suppl (Wien) 2008; 102: 93-97
4 Chibbaro S, Marsella M, Romano A, Ippolito S, Benericetti E. Combined internal uncusectomy and decompressive craniectomy for the treatment of severe closed head injury: experience with 80 cases. J Neurosurg 2008; 108 (01) 74-79
5 Cho DY, Wang YC, Chi CS. Decompressive craniotomy for acute shaken/impact baby syndrome. Pediatr Neurosurg 1995; 23 (04) 192-198
6 Figaji AA, Fieggen AG, Peter JC. Early decompressive craniotomy in children with severe traumatic brain injury. Childs Nerv Syst 2003; 19 (09) 666-673
7 Güresir E, Vatter H, Schuss P. , et al. Rapid closure technique in decompressive craniectomy. J Neurosurg 2011; 114 (04) 954-960
8 Taylor A, Butt W, Rosenfeld J. , et al. A randomized trial of very early decompressive craniectomy in children with traumatic brain injury and sustained intracranial hypertension. Childs Nerv Syst 2001; 17 (03) 154-162
9 Yang XF, Wen L, Shen F. , et al. Surgical complications secondary to decompressive craniectomy in patients with a head injury: a series of 108 consecutive cases. Acta Neurochir (Wien) 2008; 150 (12) 1241-1247 ; discussion 1248
10 Hofmeijer J, Kappelle LJ, Algra A, Amelink GJ, van Gijn J, van der Worp HB. ; HAMLET investigators. Surgical decompression for space-occupying cerebral infarction (the Hemicraniectomy After Middle Cerebral Artery infarction with Life-threatening Edema Trial [HAMLET]): a multicentre, open, randomised trial. Lancet Neurol 2009; 8 (04) 326-333
11 Jüttler E, Schwab S, Schmiedek P. , et al; DESTINY Study Group. Decompressive Surgery for the Treatment of Malignant Infarction of the Middle Cerebral Artery (DESTINY): a randomized, controlled trial. Stroke 2007; 38 (09) 2518-2525
12 Kenning TJ, Gooch MR, Gandhi RH, Shaikh MP, Boulos AS, German JW. Cranial decompression for the treatment of malignant intracranial hypertension after ischemic cerebral infarction: decompressive craniectomy and hinge craniotomy. J Neurosurg 2012; 116 (06) 1289-1298
13 Neugebauer H, Witsch J, Zweckberger K, Jüttler E. Space-occupying cerebellar infarction: complications, treatment, and outcome. Neurosurg Focus 2013; 34 (05) E8
14 Vahedi K, Hofmeijer J, Juettler E. , et al; DECIMAL, DESTINY, and HAMLET investigators. Early decompressive surgery in malignant infarction of the middle cerebral artery: a pooled analysis of three randomised controlled trials. Lancet Neurol 2007; 6 (03) 215-222
15 Vahedi K, Vicaut E, Mateo J. , et al; DECIMAL Investigators. Sequential-design, multicenter, randomized, controlled trial of early decompressive craniectomy in malignant middle cerebral artery infarction (DECIMAL Trial). Stroke 2007; 38 (09) 2506-2517
16 Wijdicks EFM, Sheth KN, Carter BS. , et al; American Heart Association Stroke Council. Recommendations for the management of cerebral and cerebellar infarction with swelling: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2014; 45 (04) 1222-1238
17 Güresir E, Schuss P, Vatter H, Raabe A, Seifert V, Beck J. Decompressive craniectomy in subarachnoid hemorrhage. Neurosurg Focus 2009; 26 (06) E4
18 Otani N, Nawashiro H, Wada K. , et al. Surgical results after primary decompressive craniectomy in poor-grade aneurysmal subarachnoid hemorrhage. Acta Neurochir Suppl (Wien) 2013; 118: 269-272
19 Hayes SB, Benveniste RJ, Morcos JJ, Aziz-Sultan MA, Elhammady MS. Retrospective comparison of craniotomy and decompressive craniectomy for surgical evacuation of nontraumatic, supratentorial intracerebral hemorrhage. Neurosurg Focus 2013; 34 (05) E3
20 Heuts SG, Bruce SS, Zacharia BE. , et al. Decompressive hemicraniectomy without clot evacuation in dominant-sided intracerebral hemorrhage with ICP crisis. Neurosurg Focus 2013; 34 (05) E4
21 Takeuchi S, Wada K, Nagatani K, Otani N, Mori K. Decompressive hemicraniectomy for spontaneous intracerebral hemorrhage. Neurosurg Focus 2013; 34 (05) E5
22 Aaron S, Alexander M, Moorthy RK. , et al. Decompressive craniectomy in cerebral venous thrombosis: a single centre experience. J Neurol Neurosurg Psychiatry 2013; 84 (09) 995-1000
23 Rajan Vivakaran TT, Srinivas D, Kulkarni GB, Somanna S. The role of decompressive craniectomy in cerebral venous sinus thrombosis. J Neurosurg 2012; 117 (04) 738-744
24 Cooper DJ, Rosenfeld JV, Murray L. , et al; DECRA Trial Investigators; Australian and New Zealand Intensive Care Society Clinical Trials Group. Decompressive craniectomy in diffuse traumatic brain injury. N Engl J Med 2011; 364 (16) 1493-1502
25 Honeybul S, Ho KM. Long-term complications of decompressive craniectomy for head injury. J Neurotrauma 2011; 28 (06) 929-935
26 Beauchamp KM, Kashuk J, Moore EE. , et al. Cranioplasty after postinjury decompressive craniectomy: is timing of the essence?. J Trauma 2010; 69 (02) 270-274
27 Chang V, Hartzfeld P, Langlois M, Mahmood A, Seyfried D. Outcomes of cranial repair after craniectomy. J Neurosurg 2010; 112 (05) 1120-1124
28 Gooch MR, Gin GE, Kenning TJ, German JW. Complications of cranioplasty following decompressive craniectomy: analysis of 62 cases. Neurosurg Focus 2009; 26 (06) E9
29 Liang W, Xiaofeng Y, Weiguo L. , et al. Cranioplasty of large cranial defect at an early stage after decompressive craniectomy performed for severe head trauma. J Craniofac Surg 2007; 18 (03) 526-532
30 Shoakazemi A, Flannery T, McConnell RS. Long-term outcome of subcutaneously preserved autologous cranioplasty. Neurosurgery 2009; 65 (03) 505-510 ; discussion 510
31 Stephens FL, Mossop CM, Bell RS. , et al. Cranioplasty complications following wartime decompressive craniectomy. Neurosurg Focus 2010; 28 (05) E3
32 Walcott BP, Kwon CS, Sheth SA. , et al. Predictors of cranioplasty complications in stroke and trauma patients. J Neurosurg 2013; 118 (04) 757-762
33 Bowers CA, Riva-Cambrin J, Hertzler II DA, Walker ML. Risk factors and rates of bone flap resorption in pediatric patients after decompressive craniectomy for traumatic brain injury. J Neurosurg Pediatr 2013; 11 (05) 526-532
34 Dünisch P, Walter J, Sakr Y, Kalff R, Waschke A, Ewald C. Risk factors of aseptic bone resorption: a study after autologous bone flap reinsertion due to decompressive craniotomy. J Neurosurg 2013; 118 (05) 1141-1147
35 Grant GA, Jolley M, Ellenbogen RG, Roberts TS, Gruss JR, Loeser JD. Failure of autologous bone-assisted cranioplasty following decompressive craniectomy in children and adolescents. J Neurosurg 2004; 100 (2, Suppl Pediatrics): 163-168
36 van Lindert EJ, Delye H, Leonardo J. Prospective review of a single center's general pediatric neurosurgical intraoperative and postoperative complication rates. J Neurosurg Pediatr 2014; 13 (01) 107-113
37 Rocque BG, Amancherla K, Lew SM, Lam S. Outcomes of cranioplasty following decompressive craniectomy in the pediatric population. J Neurosurg Pediatr 2013; 12 (02) 120-125
38 Lerch KD. Reliability of cranial flap fixation techniques: comparative experimental evaluation of suturing, titanium miniplates, and a new rivet-like titanium clamp (CranioFix): technical note. Neurosurgery 1999; 44 (04) 902-905
39 Honeybul S, Janzen C, Kruger K, Ho KM. Decompressive craniectomy for severe traumatic brain injury: is life worth living?. J Neurosurg 2013; 119 (06) 1566-1575
40 Honeybul S, Ho KM, Lind CR. What can be learned from the DECRA study. World Neurosurg 2013; 79 (01) 159-161
41 Timmons SD, Ullman JS, Eisenberg HM. Craniectomy in diffuse traumatic brain injury. N Engl J Med 2011; 365 (04) 373-376 ; author reply 376