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神经心理学变化与颅骨修补术:一项群组分析。

Neuropsychological changes and cranioplasty: A group analysis.

作者信息

Di Stefano Cristina, Rinaldesi Maria Luisa, Quinquinio Cristina, Ridolfi Chiara, Vallasciani Massimo, Sturiale Carmelo, Piperno Roberto

机构信息

a Centro Studi per la Ricerca sul Coma , Bologna , Italia.

b Casa dei Risvegli Luca De Nigris , Dipartimento Emergenza , Ausl , Bologna , Italia.

出版信息

Brain Inj. 2016;30(2):164-71. doi: 10.3109/02699052.2015.1090013. Epub 2015 Dec 8.

Abstract

BACKGROUND

Cranioplasty is the surgical answer to cranial defect due to decompressive craniectomy in order to increase patient's safety and for cosmetic reasons. Two main neurological sequelae of skull breaches have been described and cranioplasty has been suggested as a way to treat these neurological symptoms, but its effects on cognitive and motor functions are still unclear.

MATERIALS AND METHODS

In order to better elucidate if and to what extent the cranioplasty affects the whole array of cognitive functions or just some specific domains, 29 patients were studied pre- and post-cranioplasty, with structured assessments of memory, attention, language and executive functioning performed ~ 4 months and 1 month before cranioplasty and 1 month and 6 months after surgery.

RESULTS AND CONCLUSION

Cranioplasty affects the cognitive profile with a non-specific pattern of change. Timing of the cranioplasty plays a key role to enucleate cognitive improvement, indeed greater cognitive changes were seen in patients who had cranioplasty within 6 months following the injury. Thus, cranioplasty must be considered a key factor in neuropsychological recovery and should be performed as soon as possible following the injury in order to take advantage of the window of opportunity for rehabilitation.

摘要

背景

颅骨修补术是针对因减压性颅骨切除术导致的颅骨缺损的手术解决方案,目的是提高患者安全性并出于美容原因。颅骨缺损的两个主要神经后遗症已被描述,颅骨修补术被认为是治疗这些神经症状的一种方法,但其对认知和运动功能的影响仍不清楚。

材料与方法

为了更好地阐明颅骨修补术是否以及在多大程度上影响整个认知功能范围或只是某些特定领域,对29例患者在颅骨修补术前和术后进行了研究,在颅骨修补术前约4个月和1个月以及术后1个月和6个月对记忆、注意力、语言和执行功能进行了结构化评估。

结果与结论

颅骨修补术以非特异性的变化模式影响认知概况。颅骨修补术的时机对揭示认知改善起着关键作用,实际上,在受伤后6个月内进行颅骨修补术的患者中观察到了更大的认知变化。因此,颅骨修补术必须被视为神经心理恢复的关键因素,并且应在受伤后尽快进行,以便利用康复的机会窗口。

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