scholarly journals Change of Levels of NGF, ACTH, and AVP in the Cerebrospinal Fluid after Decompressive Craniectomy of Craniocerebral Injury and Their Relationship with Communicating Hydrocephalus

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Liang Wang ◽  
Shuangbo Fan ◽  
Zhenping Zhao ◽  
Qian Xu
Keyword(s):  
Decompressive Craniectomy ◽  
Craniocerebral Trauma ◽  
Difficult Problem ◽  
Clinical Treatment ◽  
Communicating Hydrocephalus ◽  
Subdural Effusion ◽  
Craniocerebral Injury ◽  
Traumatic Subarachnoid Hemorrhage ◽  
Independent Risk Factors ◽  
Postoperative Hydrocephalus

In recent years, the incidence of craniocerebral trauma has increased, making it one of the important causes of death and disability in neurosurgery patients. The decompressive craniectomy (DC) after severe craniocerebral injury has become the preferred treatment for patients with severe craniocerebral injury, but the incidence of postoperative hydrocephalus has become a difficult problem in clinical treatment. This study observed the changes of nerve growth factor (NGF), adrenocorticotropic hormone (ACTH), and arginine vasopressin (AVP) levels in the CSF after DC in patients with craniocerebral injury and analyzed the relationship between the three indicators and communicating hydrocephalus. The results showed that the levels of NGF, ACTH, and AVP in patients with cranial injury after DC were significantly higher than those in healthy subjects, and subdural effusion, traumatic subarachnoid hemorrhage (tSAH), and the levels of NGF, ACTH, and AVP in the CSF were independent risk factors for communicating hydrocephalus. Monitoring the levels of NGF, ACTH, and AVP is of great significance for clinicians to judge the occurrence of traffic hydrocephalus, evaluate the prognosis of patients with craniocerebral injury after DC, and guide clinical treatment.

scholarly journals Cranioplasty as the treatment for contralateral subdural effusion secondary to decompressive craniectomy: a case report and review of the relevant literature

2020 ◽  
Vol 48 (11) ◽  
pp. 030006052096689
Author(s):  
Hao Wang ◽  
Fumei Chen ◽  
Liang Wen ◽  
Yuanrun Zhu ◽  
Zuobing Chen ◽  
...  
Keyword(s):  
Case Report ◽  
Decompressive Craniectomy ◽  
Clinical Course ◽  
Relevant Literature ◽  
Favourable Outcome ◽  
Communicating Hydrocephalus ◽  
Subdural Effusion ◽  
Current Case ◽  
Shunt Procedure ◽  
Alternative Treatment Option

Subdural effusion (SDE) is a common complication secondary to decompressive craniectomy (DC). This current case report describes a patient with contralateral SDE with a typical clinical course. Initially, he made a good recovery following a head trauma that caused a loss of consciousness and was treated with decompressive craniectomy. However, he only achieved temporary relief after each percutaneous fluid aspiration from an Ommaya reservoir implanted into the cavity of the SDE. He was eventually transferred to the authors’ hospital where he underwent cranioplasty, which finally lead to the reduction and disappearance of his contralateral SDE. Unexpectedly, his clinical condition deteriorated again 2 weeks after the cranioplasty with symptoms of an uncontrolled bladder. A subsequent CT scan found the apparent expansion of the whole cerebral ventricular system, indicating symptomatic communicating hydrocephalus. He then underwent a ventriculoperitoneal shunt procedure, which resulted in a favourable outcome and he was discharged 2 weeks later. A review of the current literature identified only 14 cases of contralateral SDE that were cured by cranioplasty alone. The mechanism of contralateral SDE has been widely discussed. Although the exact mechanism of contralateral SDE and why cranioplasty is effective remain unclear, cranioplasty could be an alternative treatment option for contralateral SDE.

scholarly journals Neural Network Segmentation Algorithm-Based Magnetic Resonance Imaging to Explore the Relationship between Cerebrospinal Fluid Flow with Communicating Hydrocephalus after Decompressive Craniectomy for Craniocerebral Injury

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Yan Wang ◽  
Yanmin Zhang ◽  
Chunyue Zhang
Keyword(s):  
Neural Network ◽  
Cerebrospinal Fluid ◽  
Fluid Flow ◽  
Decompressive Craniectomy ◽  
Segmentation Algorithm ◽  
Communicating Hydrocephalus ◽  
Craniocerebral Injury ◽  
Resonance Imaging ◽  
Cerebrospinal Fluid Flow ◽  
The Relationship

This study aimed to explore the application value of magnetic resonance imaging optimized by neural network segmentation algorithm in analyzing the relationship between cerebrospinal fluid changes after decompressive craniectomy and the occurrence of communicating hydrocephalus. 100 patients with craniocerebral injury undergoing decompressive craniectomy in hospital were selected as research subjects. The collected MRI images were processed using the OTSU algorithm, the cerebrospinal fluid flow rate was calculated based on the observation results, and the MRI based on the neural network segmentation algorithm was used to analyze the relationship between the occurrence of communicating hydrocephalus with the cerebrospinal fluid flow after decompressive craniectomy for craniocerebral injury. Additionally, the dynamics of the flow of cerebrospinal fluid in the midbrain aqueduct was analyzed. After decompressive craniectomy for craniocerebral injury, of the 24 cases of cerebrospinal fluid accumulation, 23 cases had hydrocephalus; of the 55 cases of cerebrospinal fluid flow disorder, hydrocephalus occurred in 47 cases; and of the 21 cases of normal cerebrospinal fluid, no patients had hydrocephalus. For patients with communicating hydrocephalus, the cerebrospinal fluid flow at the aqueduct was obviously accelerated and the flow was increased. From this, the differential diagnosis of cerebrospinal fluid and communicating hydrocephalus can be further confirmed. The results showed that the third ventricle of the study group was significantly reduced, and the flow of cerebrospinal fluid was similar to that of normal people. It suggested that decompressive craniectomy can relieve communicating hydrocephalus. In patients with communicating hydrocephalus, the cerebrospinal fluid flow at the aqueduct was significantly accelerated, the flow amount was increased, and the blocked flow of cerebrospinal fluid can also lead to hydrocephalus, which further clarified the relationship between the occurrence of communicating hydrocephalus with the flow of cerebrospinal fluid. In short, the neural network segmentation algorithm-based magnetic resonance imaging demonstrated a good value in the analysis of craniocerebral injury, from which the doctor observed that the cerebrospinal fluid flow at the aqueduct was significantly accelerated. Its detection of brain complications after decompressive craniectomy was also effective.

scholarly journals Logistic Regression Analysis of Relationship between Changes of Cerebrospinal Fluid and Communicating Hydrocephalus after Decompressive Craniectomy in Craniocerebral Injury under Computed Tomography Images

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Long Sun ◽  
Haitao Wang ◽  
Jian Huang
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Intraventricular Hemorrhage ◽  
Communicating Hydrocephalus ◽  
Craniocerebral Injury ◽  
Bone Window ◽  
Second Surgery ◽  
Independent Risk Factors ◽  
Gcs Score ◽  
Window Area

This paper aimed to explore the application value of CT imaging in the correlation analysis of communicating hydrocephalus (CH) after decompressive craniectomy (DC) of craniocerebral injury (CI). 410 patients with craniocerebral trauma who were admitted to the hospital from October 2015 to October 2019 were taken as subjects, among which 130 patients suffered from CH. All patients underwent craniocerebral CT examination, and logistic regression was applied to analyze the risk factors of hydrocephalus in CI and hydrocephalus after DC surgery. The results showed that the coma time (OR = 5.1283, P = 0.001 ), subarachnoid hemorrhage (SAH) (OR = 7.6543, P = 0.020 ), Glasgow Coma Scale (GCS) score no more than 8 points (OR = 3.5480, P = 0.001 ), intraventricular hemorrhage (OR = 2.2653, P = 0.003 ), cerebral contusion and laceration (OR = 1.036, P = 0.002 ), and subdural hemorrhage (OR = 2.4376, P = 0.001 ) were independent risk factors for CH. Bilateral DC (OR = 15.342, P = 0.023 ), second surgery (OR = 7.021, P = 0.004 ), bone window height (OR = 6.543, P = 0.041 ), and bone window area (OR = 1.035, P = 0.012 ) were independent risk factors for CH after DC surgery. It suggested that CT imaging technology could be utilized in the diagnosis of CI. The risk factors of CH included coma time, SAH, GCS score no more than 8, intraventricular hemorrhage, brain contusion, subdural hematoma, bilateral DC, bone window height, bone window area, and second surgery.

scholarly journals An Analysis on the Clinical Features of MHD Patients with Coronavirus Disease 2019: A Single Center Study

2020 ◽  
Author(s):  
cheng li ◽  
Min Yonglong ◽  
Tu Can ◽  
Mao Dongdong ◽  
Wan Sheng ◽  
...  
Keyword(s):  
Clinical Treatment ◽  
Total Carbon ◽  
Maintenance Hemodialysis ◽  
Control Group ◽  
Single Center Study ◽  
Patients With Diabetes ◽  
Independent Risk Factors ◽  
Multiple Abnormalities ◽  
Death Cases ◽  
Hemodialysis Duration

Abstract Background: In this study, we aimed to find out the features of the maintenance hemodialysis (MHD) patients infected with Coronavirus Disease 2019 (COVID-19) in the Blood Purification Center of Wuhan No.1 Hospital, Hubei Province, China, and provide evidences for clinical treatment.Methods: We collected the data of all the MHD patients in this hemodialysis center by February 20, 2020, including those infected with COVID-19. These patients were divided into three groups: the control group (537 cases), confirmed group (66 cases) and suspected group (24 cases). We compared the relevant data of the three groups and analyzed the factors that may affect the possibility of catching COVID-19.Results: 1. By February 20, 2020, there were 627 MHD patients in the Hemodialysis Center of Wuhan No.1 Hospital. The prevalence rate of the COVID-19 was 14.35% (90/627, including 66 confirmed cases and 24 suspected cases); the fatality rate 13.33% (12/90, including 12 death cases); the mortality rate 1.91% (12/627).2. The comparison between the three groups revealed the following results: weekly hemodialysis duration (WHD), ultrafiltration volume (UFV) and ultrafiltration rate (UFR) of the confirmed group were obviously lower than those of the control and suspected groups (P＜0.05); the neutrophil ratio (N%), neutrophil (N#), monocyte (M#) and total carbon dioxide (TCO2) were significantly higher than those of the control group while the lymphocyte ratio (L%) was much lower (P＜0.05).3. The lung CT scans found three common features: bilateral abnormalities (81.54%), multiple abnormalities (84.62%) and patchy opacity (61.54%).4. The binary logstic regression analysis showed that diabetes (OR=5.404,95% CI 1.950～14.976, P=0.001) and hypertension (OR=3.099,95% CI 1.380～6.963, P=0.006) are independent risk factors for MHD patients to be infected with COVID-19; WHD (OR=0.846,95% CI 0.737～0.970, P=0.017), UFR (OR=0.012,95% CI 0.002～0.058, P＜0.001) and serum ferritin (SF, OR=0.823,95% CI 0.748～0.906, P＜0.001) are independent protective factors.Conclusion: MHD patients with diabetes or hypertension are more likely to be infected with COVID-19. In clinical treatment, hemodialysis duration, UFR and SF levels should be controlled appropriately to reduce the risk of infection.

scholarly journals Super early cranial repair improves the prognosis of patients with craniocerebral injury

2020 ◽  
Vol 48 (9) ◽  
pp. 030006052095948
Author(s):  
Hong-sheng Jiang ◽  
Yan-zhou Wang
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Performance Status ◽  
Craniocerebral Trauma ◽  
Clear Correlation ◽  
Craniocerebral Injury ◽  
Function Score ◽  
Psychological Function ◽  
Life Score

Objective Craniocerebral injury has high disability and mortality rates. The timing of cranioplasty has an important impact on patients’ prognosis. This study was performed to compare the functional prognosis between super early repair and conventional repair. Methods This observational study included 60 patients who underwent cranioplasty after surgical treatment of severe craniocerebral trauma. The patients were divided into two groups according to the time of cranial repair after the surgical treatment of craniocerebral injury: the super early group and the conventional repair group. Sex, age, Karnofsky performance status (KPS) score, Zubrod performance status (ZPS) score, psychological function score, quality of life score, and complications were recorded. Results The KPS score, ZPS score, psychological function score, and quality of life score were significantly related to the intervention period. Each of these scores had a clear correlation with the performance of super early treatment. Conclusion Super early cranial repair does not increase the incidence of surgical complications, and it can improve the postoperative KPS, ZPS, and quality of life scores.

POSTOPERATIVE HYDROCEPHALUS IN PATIENTS UNDERGOING DECOMPRESSIVE HEMICRANIECTOMY FOR ISCHEMIC OR HEMORRHAGIC STROKE

Neurosurgery ◽  
2007 ◽  
Vol 61 (3) ◽  
pp. 489-494 ◽  
Author(s):  
Allen Waziri ◽  
David Fusco ◽  
Stephan A. Mayer ◽  
Guy M. McKhann ◽  
E. Sander Connolly
Keyword(s):  
Intracranial Pressure ◽  
Hemorrhagic Stroke ◽  
Communicating Hydrocephalus ◽  
Imaging Data ◽  
Decompressive Hemicraniectomy ◽  
Pressure Dynamics ◽  
Csf Diversion ◽  
Postoperative Hydrocephalus ◽  
Early Cranioplasty ◽  
Persistent Hydrocephalus

Abstract OBJECTIVE We have frequently observed the development of postoperative communicating hydrocephalus in patients undergoing decompressive hemicraniectomy. This condition may persist in some patients after cranioplasty and require permanent cerebrospinal fluid (CSF) diversion. To confirm an independent correlation between hemicraniectomy and the development of communicating hydrocephalus, and to detail the frequency and potential clinical factors contributing to this complication, we evaluated our series of patients undergoing hemicraniectomy for life-threatening increases in intracranial pressure secondary to ischemic or hemorrhagic stroke. METHODS A retrospective analysis was performed with a cohort of consecutive patients who underwent emergent hemicraniectomy for medically refractory elevations in intracranial pressure. Patients with known independent risk factors for the development of communicating hydrocephalus were excluded. Clinical and imaging data were reviewed to determine the incidence and type of hydrocephalus after hemicraniectomy, the persistence of hydrocephalus after cranioplasty, and the need for permanent CSF diversion. RESULTS Eighty-eight percent of the eligible patients undergoing hemicraniectomy in our cohort developed postoperative communicating hydrocephalus. Half of these patients harbored persistent hydrocephalus after cranioplasty and required placement of a ventriculoperitoneal shunt. We noted a strong correlation between prolonged time to replacement of the bone flap and persistence of hydrocephalus. CONCLUSION Communicating hydrocephalus is an almost universal finding in patients after hemicraniectomy. Delayed time to cranioplasty is linked with the development of persistent hydrocephalus, necessitating permanent CSF diversion in some patients. We propose that early cranioplasty, when possible, may restore normal intracranial pressure dynamics and prevent the need for permanent CSF diversion in patients after hemicraniectomy.

Subdural effusion with ventriculomegaly after decompressive craniectomy for traumatic brain injury: A challenging entity

2014 ◽  
Vol 11 (2) ◽  
pp. 97-102
Author(s):  
Deepak Agrawal ◽  
Nityanand Pandey ◽  
Sumit Sinha ◽  
Deepak Gupta ◽  
G.D. Satyarthee ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Decompressive Craniectomy ◽  
Subdural Effusion

A Hypothesis of Traumatic Subdural Effusion Associated With Communicating Hydrocephalus in Infants and Its Management

2015 ◽  
Vol 26 (2) ◽  
pp. 435-437
Author(s):  
Xi Yang ◽  
Lin Shen ◽  
Que Shuang Lin ◽  
Ren Li ◽  
Nie Quanmin ◽  
...  
Keyword(s):  
Communicating Hydrocephalus ◽  
Subdural Effusion

scholarly journals Ventriculoperitoneal shunt placement with ultrasound guidance and laparoscopic assistance: 2-dimensional instructional video

2020 ◽  
Vol 11 ◽  
pp. 82
Author(s):  
Steven B. Housley ◽  
Aaron Hoffman ◽  
Adnan H. Siddiqui
Keyword(s):  
Case Report ◽  
Ventriculoperitoneal Shunt ◽  
Video Recording ◽  
Intraoperative Ultrasound ◽  
Outpatient Rehabilitation ◽  
Communicating Hydrocephalus ◽  
Safe Procedure ◽  
Shunt Placement ◽  
Postoperative Hydrocephalus ◽  
Video Case Report

Background: Postoperative communicating hydrocephalus has been described in the literature commonly associated with treatment of ruptured intracranial aneurysms; however, it is also reported to occur following other intracranial interventions such as meningioma resection and decompressive hemicraniectomy. In 2011, Burkhardt et al. reported the incidence of postoperative hydrocephalus following skull base meningioma resection was twice as high as resection of meningiomas in other regions.[1] They found that age and increased length of surgery were associated with higher rates of postoperative hydrocephalus. Our patient, a 76-year-old man, initially presented with the left-hand paresthesias and numbness before the revelation of a large sphenoid planum meningioma on workup imaging. He underwent surgical resection due to developing cranial nerve deficits and personality changes in an extensive procedure that required approximately 8 h to complete. His postoperative course, given the factors above, included the development of hydrocephalus. Case Description: He was taken to the operating room for ventriculoperitoneal shunt placement, as displayed in this video case report, which highlights our surgical and sterile techniques, intraoperative ultrasound to ensure appropriate ventricular placement, and a single-port laparoscopic technique for direct visualization of placement of the abdominal catheter. After shunt placement, his course was complicated by a small tract hemorrhage, which resolved without further treatment. He was observed to have an improvement in mental function that occurred over the following 2–3 days before being discharged to an outpatient rehabilitation facility for continued care. Conclusion: Ventriculoperitoneal shunt placement is an effective and safe procedure for the treatment of postoperative communicating hydrocephalus when performed with appropriate techniques as displayed in the associated video case report. The patient gave informed consent for surgery and video recording. Institutional Review Board approval was deemed unnecessary.

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