Corallo Francesco, Lo Buono Viviana, Calabrò Rocco Salvatore, De Cola Maria Cristina
IRCCS Centro Neurolesi "Bonino-Pulejo", Via Palermo S.S. 113, C.da Casazza, 98124 Messina, Italy.
J Clin Med. 2021 Nov 21;10(22):5437. doi: 10.3390/jcm10225437.
Cranioplasty (CP) is a neurosurgical intervention of skull repairing following a decompressive craniectomy. Unfortunately, the impact of cranioplasty on cognitive and motor function is still controversial. Fifteen TBI subjects aged 26-54 years with CP after decompressive craniectomy were selected in this observational retrospective study. As per routine clinical practice, a neuropsychological evaluation carried out immediately before the cranioplasty (Pre CP) and one month after the cranioplasty (T0) was used to measure changes due to CP surgery. This assessment was performed each year for 5 years after discharge in order to investigate long-term cognitive changes (T1-T5). Before cranioplasty, about 53.3% of subjects presented a mild to severe cognitive impairment and about 40.0% a normal cognition. After CP, we found a significant improvement in all neuropsychological test scores. The more significant differences in cognitive recovery were detected after four years from CP. Notably, we found significant differences between T4 and T0-T1, as well as between T5 and T0-T1-T2 in all battery tests. This retrospective study further suggests the importance of CP in the complex management of patients with TBI showing how these patients might improve their cognitive function over a long period after the surgical procedure.
颅骨修补术（CP）是在减压性颅骨切除术后进行颅骨修复的神经外科手术。不幸的是，颅骨修补术对认知和运动功能的影响仍存在争议。在这项观察性回顾性研究中，选取了15名年龄在26 - 54岁之间、接受减压性颅骨切除术后进行颅骨修补术的创伤性脑损伤（TBI）患者。按照常规临床实践，在颅骨修补术前（术前CP）和颅骨修补术后1个月（T0）进行神经心理学评估，以测量颅骨修补术手术引起的变化。出院后的5年里，每年都进行这项评估，以调查长期的认知变化（T1 - T5）。在颅骨修补术前，约53.3%的患者存在轻度至重度认知障碍，约40.0%认知正常。颅骨修补术后，我们发现所有神经心理学测试分数均有显著改善。在颅骨修补术后四年，认知恢复方面的差异更为显著。值得注意的是，在所有成套测试中，我们发现T4与T0 - T1之间以及T5与T0 - T1 - T2之间存在显著差异。这项回顾性研究进一步表明了颅骨修补术在TBI患者综合管理中的重要性，显示了这些患者在手术后的很长一段时间内认知功能可能如何改善。
