Kropla Fabian, Wach Johannes, Winkler Dirk, Grunert Ronny, Güresir Erdem, Vychopen Martin
Department of Neurosurgery, University of Leipzig Medical Center, Leipzig, Germany.
Frauenhofer Institute for Machine Tools and Forming Technology, Zittau, Germany.
Front Bioeng Biotechnol. 2025 Apr 11;13:1530126. doi: 10.3389/fbioe.2025.1530126. eCollection 2025.
Decompressive hemicraniectomy (DC) is a procedure used to treat elevated, therapy-refractory intracranial pressure. Despite the severity of the underlying pathology, selected patients quickly regain mobility and are at risk of secondary injury due to the post-craniotomy defect. A 3D-printed helmet offers a quickly available and safe solution. Up to now, postoperative CT scans have been used as a template for helmet construction. In this study, we present an alternative helmet construction using a non-invasive 3D scan (ArtecLeo, Artec3D), which is used to capture craniometrics data, plan the shape of the helmet, and compare it with routinely performed CT scans. A significant difference in defect displacement between supine scans and standing or sitting scans is evident, which is quantified.
We included six patients who underwent decompressive craniectomy due to therapyrefractory elevation of intracranial pressure as a consequence of following pathologies: large intracerebral hemorrhage, large cerebral infarction, sever traumatic brain injury and poor grade subarachnoid hemorrhage. All patients underwent 3-D scan and subsequently, a helmet was created to cover the craniectomy area.
A surface heat-map comparison was performed to demonstrate the differences between the data obtained by 3-D scan (lying and sitting position) and CT-scan. Furthermore, the heat-map demonstrates the frontal and posterior surface difference between CT-scan and sitting position. Comparing the lying position 3-D scan and CT-scan, we were able to demonstrate a tissue shift, mainly in cranial and frontal areas.
We demonstrated that non-invasive 3D-scan (Artec3D) is a feasible alternative to scan the head of the patients after DHC in order to construct a 3D-printed Helm. According to the heat-map analysis, it seems to be more reliable data assessment method in independently moving patients.
减压性颅骨切除术（DC）是一种用于治疗顽固性颅内压升高的手术。尽管潜在病理状况严重，但部分患者能迅速恢复活动能力，且因开颅术后颅骨缺损面临二次损伤风险。3D打印头盔提供了一种快速可用且安全的解决方案。到目前为止，术后CT扫描一直被用作头盔制作的模板。在本研究中，我们提出一种使用非侵入性3D扫描（ArtecLeo，Artec3D）的替代头盔制作方法，该扫描用于获取颅骨测量数据、规划头盔形状，并与常规进行的CT扫描进行比较。仰卧位扫描与站立或坐位扫描之间的缺损移位存在显著差异，对此进行了量化。
我们纳入了6例因以下病理情况导致颅内压顽固性升高而接受减压性颅骨切除术的患者：大面积脑出血、大面积脑梗死、重度创伤性脑损伤和低级别蛛网膜下腔出血。所有患者均接受了3D扫描，随后制作了覆盖颅骨切除区域的头盔。
进行了表面热图比较，以展示3D扫描（卧位和坐位）和CT扫描所获数据之间的差异。此外，热图显示了CT扫描与坐位之间的前后表面差异。比较卧位3D扫描和CT扫描，我们能够证明主要在颅骨和额部区域存在组织移位。
我们证明，非侵入性3D扫描（Artec3D）是DHC术后扫描患者头部以构建3D打印头盔的一种可行替代方法。根据热图分析，对于自主活动的患者，它似乎是更可靠的数据评估方法。
