Wu Yu-Ying, Chen Han-Jung, Lu Kang, Lin I-Fan
School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
Department of Neurosurgery, E-Da Hospital, Kaohsiung, Taiwan.
Neurotrauma Rep. 2022 Aug 22;3(1):333-338. doi: 10.1089/neur.2022.0033. eCollection 2022.
Cranioplasty to reconstruct a skull defect after a decompressive craniectomy (DC) is a common neurosurgical procedure. However, cranioplasty is associated with relatively high complication rates, with optimal timing from craniectomy to cranioplasty remaining a controversial matter. Recent studies demonstrated early cranioplasty with appropriate risk mitigation to be a viable option with many clinical advantages, propelling the advocacy for cranioplasty as soon as brain swelling resolves. We report on a 33-year-old male with traumatic brain injury who received an early cranioplasty, 18 days post-DC. The extent of adequate brain swelling resolution was determined by superimposing selected pre-cranioplasty computed tomography (CT) images onto corresponding pre-craniectomy CT images. By ensuring all brain matter lies within the outer table of the skull in superimposed brain images, the extent of brain swelling resolution could be determined reliably and the feasibility of cranioplasty can be assessed objectively.
颅骨成形术用于在减压性颅骨切除术后重建颅骨缺损，是一种常见的神经外科手术。然而，颅骨成形术的并发症发生率相对较高，从颅骨切除到颅骨成形术的最佳时机仍是一个有争议的问题。最近的研究表明，早期颅骨成形术并适当降低风险是一种可行的选择，具有许多临床优势，促使人们主张在脑肿胀消退后尽快进行颅骨成形术。我们报告了一名33岁的男性创伤性脑损伤患者，在减压性颅骨切除术后18天接受了早期颅骨成形术。通过将选定的颅骨成形术前计算机断层扫描（CT）图像叠加到相应的颅骨切除术前CT图像上，确定脑肿胀充分消退的程度。通过确保在叠加的脑图像中所有脑实质位于颅骨外板内，可以可靠地确定脑肿胀消退的程度，并客观地评估颅骨成形术的可行性。
