Decompressive craniectomy with watertight duroplasty and without watertight duroplasty – advantages and disadvantages

Česká verzia

Authors: Š. Trnka ¹; L. Jurák ²; D. Krahulík ¹; P. Stejskal ¹; J. Jablonský ¹; L. Hrabálek ¹; D. Pohlodek ¹
Authors place of work: Neurochirurgická klinika LF UP a FN Olomouc ¹; Krajská nemocnice Liberec, a. s. ²
Published in the journal: Cesk Slov Neurol N 2023; 86(1): 69-73
Category: Original Paper
doi: https://doi.org/10.48095/cccsnn202369

Summary

Background: Decompressive craniectomy (DC) is a life-saving neurosurgical procedure with several technical options. Aim: The aim of this study was to compare the results of the DC surgical technique with and without duroplasty performed at two neurosurgery departments. Methods: A retrospective bicentric study evaluated the occurrence of complications (i.e., infection, cerebrospinal fluid fistula, hematoma) in both compared techniques. Results: The study did not demonstrate a statistically significantly higher incidence of complications such as infection (P = 0.539), cerebrospinal fluid fistula (P = 0.826) or hematoma (P = 0.720). No infectious complications or cerebrospinal fluid fistula were recorded in both observed groups after cranioplasty. The complication in the form of hematoma was statistically insignificant (P = 0.155). A statistically significant difference was found in the operative time of cranioplasty performed after DC with duroplasty (median 53 min) and after DC without duroplasty (median 90 min; P = 0.006). Conclusion: DC without duroplasty is a potentially safe option that is not burdened by a higher incidence of complications in terms of infection or the formation of cerebrospinal fluid fistula and hematoma.

Keywords:

decompressive craniectomy – traumatic brain injury – cranioplasty – duroplasty

Zdroje

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