Department of Radiology Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB20QQ, England.
Radiographics. 2010 Mar;30(2):461-82. doi: 10.1148/rg.302095115.
Imaging plays an essential role in the evaluation of patients after cranial surgery. It is important to be familiar with the normal anatomy of the cranium; the indications for different surgical techniques such as burr holes, craniotomy, craniectomy, and cranioplasty; their normal postoperative appearances; and complications such as tension pneumocephalus, infection, abscess, empyema, hemorrhage, hematoma, herniation, hygroma, and trephine syndrome. Postoperative infection and hemorrhage are common to all neurosurgical procedures, where-as other complications are peculiar to certain procedures (eg, drill "plunging" during burr hole creation and sinking skin flap after craniec-tomy). Recognizing life-threatening complications such as tension pneumocephalus and paradoxical herniation, which require urgent intervention, is important for a better clinical outcome. Computed tomography is fast, cost effective, and easily accessible for first-line imaging. Magnetic resonance imaging has higher sensitivity for detecting postoperative infection and ischemia, but diffusion-weighted imaging may be less reliable for detecting postoperative infections.
影像学在颅脑手术后患者的评估中起着至关重要的作用。熟悉颅骨的正常解剖结构、不同手术技术（如颅骨钻孔术、开颅术、颅骨切除术和颅骨成形术）的适应证、正常术后表现以及并发症（如张力性气颅、感染、脓肿、积脓、出血、血肿、脑疝、皮下血肿和环钻综合征）非常重要。术后感染和出血是所有神经外科手术的常见并发症，而其他并发症则是某些手术特有的（例如，颅骨钻孔术时钻头“刺入”和颅骨切除术后头皮瓣下沉）。认识到危及生命的并发症（如张力性气颅和矛盾性脑疝）需要紧急干预，这对获得更好的临床结果非常重要。计算机断层扫描快速、具有成本效益，并且易于进行一线成像。磁共振成像对检测术后感染和缺血具有更高的敏感性，但扩散加权成像对检测术后感染可能不太可靠。
