Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Epidural Fluid Collection after Cranioplasty : Fate and Predictive Factors

  • Lee, Jung-Won (Department of Neurosurgery, Eulji University School of Medicine, Nowon Eulji Hospital) ;
  • Kim, Jae-Hoon (Department of Neurosurgery, Eulji University School of Medicine, Nowon Eulji Hospital) ;
  • Kang, Hee-In (Department of Neurosurgery, Eulji University School of Medicine, Nowon Eulji Hospital) ;
  • Moon, Byung-Gwan (Department of Neurosurgery, Eulji University School of Medicine, Nowon Eulji Hospital) ;
  • Lee, Seung-Jin (Department of Neurosurgery, Eulji University School of Medicine, Nowon Eulji Hospital) ;
  • Kim, Joo-Seung (Department of Neurosurgery, Eulji University School of Medicine, Nowon Eulji Hospital)
  • Received : 2011.04.25
  • Accepted : 2011.09.14
  • Published : 2011.09.28
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Abstract

Objective : Infection and bone resorption are major complications of cranioplasty and have been well recognized. However, there are few clinical series describing the epidural fluid collection (EFC) as complication of cranioplasty. This study was planned to identify the predictive factors and fate of EFC after cranioplasty. Methods : We reviewed retrospectively the demographic, clinical, and radiographic data in 59 patients who underwent a first cranioplsty following decompressive craniectomy during a period of 6 years, from January 2004 to December 2009. We compared demographic, clinical, and radiographic factors between EFC group and no EFC group. The predictive factors associated with the development of EFC were assessed by logistic regression analysis. Results : Overall, 22 of 59 patients (37.3%) suffered from EFC following cranioplasty. EFC had disappeared (n=6, 31.8%) or regressed (n=6, 31.8%) over time on follow up brain computed tomographic (CT) scans. However, 5 patients (22.7%) required reoperation due to symptomatic and persistent EFC. Predictive factors for EFC were male [odds ratio (OR), 5.48; 95% CI, 1.26-23.79], air bubbles in the epidural space (OR, 12.52; 95% CI, 2.26-69.28), and dural calcification on postoperative brain CT scan (OR, 4.21; 95% CI, 1.12-15.84). Conclusion : The most of EFCs could be treated by conservative therapy. Air bubble in the epidural space and dural calcification are proposed to be the predictive factors in the formation of EFC after cranioplasty.

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References

  1. Aarabi B, Hesdorffer DC, Ahn ES, Aresco C, Scalea TM, Eisenberg HM : Outcome following decompressive craniectomy for malignant swelling due to severe head injury. J Neurosurg 104 : 469-479, 2006 https://doi.org/10.3171/jns.2006.104.4.469
  2. AFRA D : Ossification of subdural hematoma. Reports of two cases. J Neurosurg 18 : 393-397, 1961 https://doi.org/10.3171/jns.1961.18.3.0393
  3. Aoki N : Air in acute epidural hematoma. Report of two cases. J Neurosurg 65 : 555-556, 1986 https://doi.org/10.3171/jns.1986.65.4.0555
  4. Beauchamp KM, Kashuk J, Moore EE, Bolles G, Rabb C, Seinfeld J, et al. : Cranioplasty after postinjury decompressive craniectomy : is timing of the essence? J Trauma 69 : 270-274, 2010 https://doi.org/10.1097/TA.0b013e3181e491c2
  5. Chang JH, Choi JY, Chang JW, Park YG, Kim TS, Chung SS : Chronic epidural hematoma with rapid ossification. Childs Nerv Syst 18 : 712-716, 2002 https://doi.org/10.1007/s00381-002-0664-2
  6. Chang V, Hartzfeld P, Langlois M, Mahmood A, Seyfried D : Outcomes of cranial repair after craniectomy. J Neurosurg 112 : 1120-1124, 2010 https://doi.org/10.3171/2009.6.JNS09133
  7. Debois V, Lombaert A : Calcified chronic subdural hematoma. Surg Neurol 14 : 455-458, 1980
  8. Gooch MR, Gin GE, Kenning TJ, German JW : Complications of cranioplasty following decompressive craniectomy : analysis of 62 cases. Neusurg Focus 26 : E9, 2009
  9. Guerra WK, Gaab MR, Dietz H, Mueller JU, Piek J, Fritsch MJ : Surgical decompression for traumatic brain swelling : indications and results. J Neurosurg 90 : 187-196, 1999 https://doi.org/10.3171/jns.1999.90.2.0187
  10. Imaizumi S, Owada K, Onuma T, kamii H, Nakajima T : [Epidural fluid collection after cranioplasty using hydroxyapatite ceremics following bone cement]. Jpn J Neurosurg (Tokyo) 9 : 44-47, 2000 https://doi.org/10.7887/jcns.9.44
  11. Park JS, Lee KS, Shim JJ, Yoon SM, Choi WR, Doh JW : Large defect may cause infectious complications in cranioplasty. J Korean Neurosurg Soc 42 : 89-91, 2007
  12. Stephens FL, Mossop CM, Bell RS, Tigno T Jr, Rosner MK, Kumar A, et al. : Cranioplasty complications following wartime decompressive craniectomy. Neurosug Focus 28 : E3, 2010
  13. Tamaki T, Eguchi T, Sakamoto M, Teramoto A : Use of diffusion-weighted magnetic resonance imaging in empyema after cranioplasty. Br J Neurosurg 18 : 40-44, 2004 https://doi.org/10.1080/02688690410001660445
  14. Tsuchiya K, Osawa A, Katase S, Fujikawa A, Hachiya J, Aoki S : Diffusion-weighted MRI of subdural and epidural empyemas. Neuroradiology 45 : 220-223, 2003 https://doi.org/10.1007/s00234-003-0949-5
  15. Whitfield PC, Patel H, Hutchinson PJ, Czosnyka M, Parry D, Melon D, et al. : Bifrontal decompressive craniectomy in the management of posttraumatic intracranial hypertension. Br J Neurosurg 15 : 500-507, 2001 https://doi.org/10.1080/02688690120105110

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