Chughtai Komal A, Nemer Omar P, Kessler Alexander T, Bhatt Alok A
Department of Imaging Sciences, University of Rochester Medical Center, 601 Elmwood Avenue, PO Box 648, Rochester, NY, 14642, USA.
Department of Radiology, Buffalo VA Medical Center, University at Buffalo School of Medicine and Biomedical Sciences, 3496 Bailey Avenue, Buffalo, NY, 14215, USA.
Emerg Radiol. 2019 Feb;26(1):99-107. doi: 10.1007/s10140-018-1647-2. Epub 2018 Sep 25.
Craniotomy and craniectomy are widely performed emergent neurosurgical procedures and are the prescribed treatment for a variety of conditions from trauma to cancer. It is vital for the emergency radiologist to be aware of expected neuroimaging findings in post-craniotomy and craniectomy patients in order to avoid false positives. It is just as necessary to be familiar with postsurgical complications in these patients to avoid delay in lifesaving treatment. This article will review the commonly encountered normal and abnormal findings in post-craniotomy and craniectomy patients. The expected postoperative CT and MRI appearance of these procedures are discussed, followed by complications. These include hemorrhage, tension pneumocephalus, wound/soft tissue infection, bone flap infection and extradural abscesses. Complications specifically related to craniectomies include extracranial herniation, external brain tamponade, paradoxical herniation, and trephine syndrome.
开颅手术和颅骨切除术是广泛开展的急诊神经外科手术，是治疗从创伤到癌症等各种病症的规定疗法。对于急诊放射科医生而言，了解开颅手术和颅骨切除术后患者预期的神经影像学表现至关重要，以便避免出现假阳性结果。同样有必要熟悉这些患者的术后并发症，以免延误挽救生命的治疗。本文将回顾开颅手术和颅骨切除术后患者常见的正常和异常表现。讨论了这些手术预期的术后CT和MRI表现，随后介绍了并发症。这些并发症包括出血、张力性气颅、伤口/软组织感染、骨瓣感染和硬膜外脓肿。与颅骨切除术特别相关的并发症包括颅外疝、脑外压迫、反常疝和环锯综合征。
