Reoperation-requiring postoperative intracranial haemorrhage after posterior fossa craniotomy: Retrospective case-series
Introduction: Studies report rates of treatment-requiring postoperative intracranial haemorrhage after craniotomy around 1–2%, but do not distinguish between supratentorial and posterior fossa operations. Reports about intracranial haemorrhages’ temporal occurrence show conflicting results. Recommen...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-01-01
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| Series: | Brain and Spine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772529423010299 |
| _version_ | 1797365604501422080 |
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| author | Elise K. Kristensen Kay Müller Tor Ingebrigtsen Haakon Lindekleiv Roar Kloster Jørgen G. Isaksen |
| author_facet | Elise K. Kristensen Kay Müller Tor Ingebrigtsen Haakon Lindekleiv Roar Kloster Jørgen G. Isaksen |
| author_sort | Elise K. Kristensen |
| collection | DOAJ |
| description | Introduction: Studies report rates of treatment-requiring postoperative intracranial haemorrhage after craniotomy around 1–2%, but do not distinguish between supratentorial and posterior fossa operations. Reports about intracranial haemorrhages’ temporal occurrence show conflicting results. Recommendations for duration of postoperative monitoring vary. Research question: To determine the rate, temporal pattern and clinical presentation of reoperation-requiring postoperative intracranial posterior fossa haemorrhage. Material and methods: This retrospective case-series identified cases operated with posterior fossa craniotomy or craniectomy between January 1, 2007 and December 31, 2021 by an electronic search in the patient administrative database, and collected data about patient- and treatment-characteristics, postoperative monitoring, and the occurrence of haemorrhagic and other serious postoperative complications. Results: We included 62 (n = 34, 55% women) cases with mean age 48 (interquartile range 50) years operated for tumours (n = 34, 55%), Chiari malformations (n = 18, 29%), ischemic stroke (n = 6, 10%) and other lesions (n = 3, 5%). One (2%) 66-year-old woman who was a daily smoker operated with decompressive craniectomy and infarct resection, developed a reoperation-requiring postoperative intracranial haemorrhage after 25.5 h. In four (6%) cases, other serious complications requiring reoperation or transfer from the post anaesthesia care unit or regular bed wards to the intensive care unit occurred after 0.5, 6, 9 and 54 h, respectively. Discussion and conclusion: Treatment-requiring postoperative intracranial haemorrhage and other serious complications after posterior fossa craniotomies occur over a wide timespan and are difficult to capture with a standardized postoperative monitoring time. This indicates that the duration of monitoring should be individualized based on assessment of risk factors. |
| first_indexed | 2024-03-08T16:51:20Z |
| format | Article |
| id | doaj.art-b32357b9e12b477fafdaa60c84967468 |
| institution | Directory Open Access Journal |
| issn | 2772-5294 |
| language | English |
| last_indexed | 2024-03-08T16:51:20Z |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brain and Spine |
| spelling | doaj.art-b32357b9e12b477fafdaa60c849674682024-01-05T04:25:24ZengElsevierBrain and Spine2772-52942024-01-014102741Reoperation-requiring postoperative intracranial haemorrhage after posterior fossa craniotomy: Retrospective case-seriesElise K. Kristensen0Kay Müller1Tor Ingebrigtsen2Haakon Lindekleiv3Roar Kloster4Jørgen G. Isaksen5Department of Clinical Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, NorwayDepartment of Clinical Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway; Department of Neurosurgery, Ophthalmology and Otorhinolaryngology, University Hospital of North Norway, Tromsø, NorwayDepartment of Clinical Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway; Department of Neurosurgery, Ophthalmology and Otorhinolaryngology, University Hospital of North Norway, Tromsø, Norway; Corresponding author. Department of Clinical Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway.Department of Clinical Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway; Department of Radiology, University Hospital of North Norway, Tromsø, NorwayDepartment of Clinical Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway; Department of Neurosurgery, Ophthalmology and Otorhinolaryngology, University Hospital of North Norway, Tromsø, NorwayDepartment of Clinical Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway; Department of Neurosurgery, Ophthalmology and Otorhinolaryngology, University Hospital of North Norway, Tromsø, NorwayIntroduction: Studies report rates of treatment-requiring postoperative intracranial haemorrhage after craniotomy around 1–2%, but do not distinguish between supratentorial and posterior fossa operations. Reports about intracranial haemorrhages’ temporal occurrence show conflicting results. Recommendations for duration of postoperative monitoring vary. Research question: To determine the rate, temporal pattern and clinical presentation of reoperation-requiring postoperative intracranial posterior fossa haemorrhage. Material and methods: This retrospective case-series identified cases operated with posterior fossa craniotomy or craniectomy between January 1, 2007 and December 31, 2021 by an electronic search in the patient administrative database, and collected data about patient- and treatment-characteristics, postoperative monitoring, and the occurrence of haemorrhagic and other serious postoperative complications. Results: We included 62 (n = 34, 55% women) cases with mean age 48 (interquartile range 50) years operated for tumours (n = 34, 55%), Chiari malformations (n = 18, 29%), ischemic stroke (n = 6, 10%) and other lesions (n = 3, 5%). One (2%) 66-year-old woman who was a daily smoker operated with decompressive craniectomy and infarct resection, developed a reoperation-requiring postoperative intracranial haemorrhage after 25.5 h. In four (6%) cases, other serious complications requiring reoperation or transfer from the post anaesthesia care unit or regular bed wards to the intensive care unit occurred after 0.5, 6, 9 and 54 h, respectively. Discussion and conclusion: Treatment-requiring postoperative intracranial haemorrhage and other serious complications after posterior fossa craniotomies occur over a wide timespan and are difficult to capture with a standardized postoperative monitoring time. This indicates that the duration of monitoring should be individualized based on assessment of risk factors.http://www.sciencedirect.com/science/article/pii/S2772529423010299CraniotomyCraniectomyPosterior fossaPostoperative complicationsPostoperative haemorrhageMonitoring |
| spellingShingle | Elise K. Kristensen Kay Müller Tor Ingebrigtsen Haakon Lindekleiv Roar Kloster Jørgen G. Isaksen Reoperation-requiring postoperative intracranial haemorrhage after posterior fossa craniotomy: Retrospective case-series Brain and Spine Craniotomy Craniectomy Posterior fossa Postoperative complications Postoperative haemorrhage Monitoring |
| title | Reoperation-requiring postoperative intracranial haemorrhage after posterior fossa craniotomy: Retrospective case-series |
| title_full | Reoperation-requiring postoperative intracranial haemorrhage after posterior fossa craniotomy: Retrospective case-series |
| title_fullStr | Reoperation-requiring postoperative intracranial haemorrhage after posterior fossa craniotomy: Retrospective case-series |
| title_full_unstemmed | Reoperation-requiring postoperative intracranial haemorrhage after posterior fossa craniotomy: Retrospective case-series |
| title_short | Reoperation-requiring postoperative intracranial haemorrhage after posterior fossa craniotomy: Retrospective case-series |
| title_sort | reoperation requiring postoperative intracranial haemorrhage after posterior fossa craniotomy retrospective case series |
| topic | Craniotomy Craniectomy Posterior fossa Postoperative complications Postoperative haemorrhage Monitoring |
| url | http://www.sciencedirect.com/science/article/pii/S2772529423010299 |
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