Corallo Francesco, De Cola Maria Cristina, Lo Buono Viviana, Marra Angela, De Luca Rosaria, Trinchera Antonia, Bramanti Placido, Calabrò Rocco Salvatore
a IRCCS Centro Neurolesi "Bonino Pulejo" , Messina , Italy.
Int J Neurosci. 2017 Aug;127(8):688-693. doi: 10.1080/00207454.2016.1235045. Epub 2016 Sep 28.
Cranioplasty is the surgical repair of skull defects, which commonly is performed after traumatic skull injuries due to tumor removal or decompressive craniectomy. Several studies reported improvement in cognitive functions following cranioplasty in patients with severe brain damage. The reasons why exist such clinical improvement is not completely understood, although the increase in cerebrospinal fluid hydrodynamics with the potential improvement of local and global cerebral hemodynamics, blood flow, and metabolism may play a pivotal role. We investigated whether the cranioplasty improved neurological recovery and the whole array of cognitive functions or just some specific domains.
A total of 30 consecutive brain-injured subjects with craniectomy were enrolled and underwent a structured neuropsychological assessment immediately before the cranioplasty, 1 month after the cranioplasty and 1 year after the surgical procedure.
Our results showed that cranioplasty may facilitate the cognitive recovery, independently from the surgical timing. Particularly, we observed an important cognitive recovery in the period immediately after cranioplasty, while the improvement trend settles after a lapse of time, and the recovery starts to slow down.
Cranioplasty seems to significantly improve neuropsychological and motor status in the patients with skull defects, independently from cranioplasty timing and patient's clinical status.
颅骨修补术是对颅骨缺损进行的外科修复，通常在因肿瘤切除或减压性颅骨切除术后的创伤性颅脑损伤后进行。几项研究报告称，严重脑损伤患者在颅骨修补术后认知功能有所改善。尽管脑脊液动力学增加以及局部和整体脑血流动力学、血流量和代谢的潜在改善可能起关键作用，但这种临床改善存在的原因尚未完全明确。我们研究了颅骨修补术是否能改善神经功能恢复和整个认知功能范围，还是仅改善某些特定领域。
共纳入30例连续的接受过颅骨切除术的脑损伤受试者，并在颅骨修补术前、颅骨修补术后1个月和手术后1年进行了结构化神经心理学评估。
我们的结果表明，颅骨修补术可促进认知恢复，与手术时机无关。特别是，我们观察到在颅骨修补术后立即出现了重要的认知恢复，而改善趋势在一段时间后趋于平稳，恢复开始放缓。
颅骨修补术似乎能显著改善颅骨缺损患者的神经心理学和运动状态，与颅骨修补术时机和患者临床状态无关。
