Honeybul Stephen, Janzen Courtney, Kruger Kate, Ho Kwok M
Department of Neurosurgery, Sir Charles Gairdner Hospital and Royal Perth Hospital, Perth, Western Australia, Australia.
Br J Neurosurg. 2013 Oct;27(5):636-41. doi: 10.3109/02688697.2013.817532. Epub 2013 Jul 25.
To assess changes in neurological function after cranioplasty.
Functional and neurocognitive assessments including activities of daily living assessment, functional independence measure (FIM) and the Cognitive assessment report (COGNISTAT) were conducted on all patients within 72 h before and 7 days after cranioplasty. A change in the total FIM score of 2 points was taken to be clinically significant.
Assessments were performed on 25 patients. The functional status was unchanged in eighteen patients (72%), four patients (16%) demonstrated a significant improvement and three patients (12%) deteriorated significantly. Those with deterioration after cranioplasty had some forms of complications including pneumocephalus or seizure. After excluding the three patients who had immediate medical or surgical complications after surgery, there was a mild overall improvement in the mean FIM score (2.1, 95% confidence interval 0.1-4.3, p = 0.049), mainly due to an improvement in their motor function.
A small but significant number of patients appear to improve clinically following cranioplasty. The so-called syndrome of the trephined may be more common than had been previously appreciated.
评估颅骨修补术后神经功能的变化。
在颅骨修补术前72小时内及术后7天对所有患者进行功能和神经认知评估，包括日常生活活动评估、功能独立性测量（FIM）和认知评估报告（COGNISTAT）。FIM总分变化2分被认为具有临床意义。
对25例患者进行了评估。18例患者（72%）功能状态未改变，4例患者（16%）有显著改善，3例患者（12%）显著恶化。颅骨修补术后病情恶化的患者有一些并发症形式，包括气颅或癫痫发作。排除术后立即出现内科或外科并发症的3例患者后，平均FIM评分有轻度总体改善（2.1，95%置信区间0.1 - 4.3，p = 0.049），主要是由于运动功能的改善。
少数患者在颅骨修补术后临床症状有改善。所谓的颅骨钻孔综合征可能比之前认为的更常见。
