Simultaneous Cranioplasty and External Ventricular Drain Implantation in Patients with Hydrocephalus: Case Series and Literature Review
Introduction The increase in intracranial pressure (ICP) is a neurological complication resulting from numerous pathologies that affect the brain and its compartments. Therefore, decompressive craniectomy (DC) is an alternative adopted to reduce ICP in emergencies, especially in cases refractory to...
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| Format: | Article |
| Language: | English |
| Published: |
Thieme Revinter Publicações Ltda.
2021-07-01
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| Series: | Brazilian Neurosurgery |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1730332 |
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| author | Lívio Pereira de Macêdo Arlindo Ugulino Netto Kauê Franke Pierre Vansant Oliveira Eugenio John Anderson da Silva Rocha Glaudir Donato Pinto Júnior João Pedro Maia Medeiros Juan Pablo Borges Rodrigues Maricevich Nivaldo S. Almeida Hildo Rocha Cirne Azevedo-Filho |
| author_facet | Lívio Pereira de Macêdo Arlindo Ugulino Netto Kauê Franke Pierre Vansant Oliveira Eugenio John Anderson da Silva Rocha Glaudir Donato Pinto Júnior João Pedro Maia Medeiros Juan Pablo Borges Rodrigues Maricevich Nivaldo S. Almeida Hildo Rocha Cirne Azevedo-Filho |
| author_sort | Lívio Pereira de Macêdo |
| collection | DOAJ |
| description | Introduction The increase in intracranial pressure (ICP) is a neurological complication resulting from numerous pathologies that affect the brain and its compartments. Therefore, decompressive craniectomy (DC) is an alternative adopted to reduce ICP in emergencies, especially in cases refractory to clinical therapies, in favor of patient survival. However, DC is associated with several complications, including hydrocephalus (HC). The present study presents the results of an unusual intervention to this complication: the implantation of an external ventricular drain (EVD) in the intraoperative period of cranioplasty (CP).
Methods Patients of both genders who presented with HC and externalization of the brain through the cranial vault after decompressive hemicraniectomy and underwent EVD implantation, to allow the CP procedure, in the same surgical procedure, were included.
Results Five patients underwent DC due to a refractory increase in ICP, due to automobile accidents, firearm projectiles, falls from stairs, and ischemic strokes. All evolved with HC. There was no uniform time interval between DC and CP. The cerebrospinal fluid (CSF) was drained according to the need for correction of cerebral herniation in each patient, before undergoing cranioplasty. All patients progressed well, without neurological deficits in the immediate postoperative period.
Conclusion There are still several uncertainties about the management of HC resulting from DC. In this context, other CP strategies simultaneous to the drainage of CSF, not necessarily related to ventriculoperitoneal shunt (VPS), should be considered and evaluated more deeply, in view of the verification of efficacy in procedures of this scope, such as the EVD addressed in this study. |
| first_indexed | 2024-12-14T08:01:57Z |
| format | Article |
| id | doaj.art-b49a296001dc47ce9a5a38aa4c67cc85 |
| institution | Directory Open Access Journal |
| issn | 0103-5355 2359-5922 |
| language | English |
| last_indexed | 2024-12-14T08:01:57Z |
| publishDate | 2021-07-01 |
| publisher | Thieme Revinter Publicações Ltda. |
| record_format | Article |
| series | Brazilian Neurosurgery |
| spelling | doaj.art-b49a296001dc47ce9a5a38aa4c67cc852022-12-21T23:10:21ZengThieme Revinter Publicações Ltda.Brazilian Neurosurgery0103-53552359-59222021-07-014004e297e30210.1055/s-0041-1730332Simultaneous Cranioplasty and External Ventricular Drain Implantation in Patients with Hydrocephalus: Case Series and Literature ReviewLívio Pereira de Macêdo0Arlindo Ugulino Netto1Kauê Franke2Pierre Vansant Oliveira Eugenio3John Anderson da Silva Rocha4Glaudir Donato Pinto Júnior5João Pedro Maia Medeiros6Juan Pablo Borges Rodrigues Maricevich7Nivaldo S. Almeida8Hildo Rocha Cirne Azevedo-Filho9Department of Neurosurgery, Hospital da Restauração, Recife, Pernambuco, BrazilDepartment of Neurosurgery, Hospital da Restauração, Recife, Pernambuco, BrazilDepartment of Neurosurgery, Hospital da Restauração, Recife, Pernambuco, BrazilCentro de Ciências Médicas, Universidade Federal da Paraíba, João Pessoa, Paraíba, BrazilDepartment of Neurosurgery, Hospital da Restauração, Recife, Pernambuco, BrazilCentro de Ciências Médicas, Universidade Federal da Paraíba, João Pessoa, Paraíba, BrazilCentro de Ciências Médicas, Universidade Federal da Paraíba, João Pessoa, Paraíba, BrazilDepartment of Plastic Surgery, Hospital da Restauração, Recife, Pernambuco, BrazilDepartment of Neurosurgery, Hospital da Restauração, Recife, Pernambuco, BrazilDepartment of Neurosurgery, Hospital da Restauração, Recife, Pernambuco, BrazilIntroduction The increase in intracranial pressure (ICP) is a neurological complication resulting from numerous pathologies that affect the brain and its compartments. Therefore, decompressive craniectomy (DC) is an alternative adopted to reduce ICP in emergencies, especially in cases refractory to clinical therapies, in favor of patient survival. However, DC is associated with several complications, including hydrocephalus (HC). The present study presents the results of an unusual intervention to this complication: the implantation of an external ventricular drain (EVD) in the intraoperative period of cranioplasty (CP). Methods Patients of both genders who presented with HC and externalization of the brain through the cranial vault after decompressive hemicraniectomy and underwent EVD implantation, to allow the CP procedure, in the same surgical procedure, were included. Results Five patients underwent DC due to a refractory increase in ICP, due to automobile accidents, firearm projectiles, falls from stairs, and ischemic strokes. All evolved with HC. There was no uniform time interval between DC and CP. The cerebrospinal fluid (CSF) was drained according to the need for correction of cerebral herniation in each patient, before undergoing cranioplasty. All patients progressed well, without neurological deficits in the immediate postoperative period. Conclusion There are still several uncertainties about the management of HC resulting from DC. In this context, other CP strategies simultaneous to the drainage of CSF, not necessarily related to ventriculoperitoneal shunt (VPS), should be considered and evaluated more deeply, in view of the verification of efficacy in procedures of this scope, such as the EVD addressed in this study.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1730332cranioplastyexternal ventricular drainpost-traumatic hydrocephalusneurosurgery |
| spellingShingle | Lívio Pereira de Macêdo Arlindo Ugulino Netto Kauê Franke Pierre Vansant Oliveira Eugenio John Anderson da Silva Rocha Glaudir Donato Pinto Júnior João Pedro Maia Medeiros Juan Pablo Borges Rodrigues Maricevich Nivaldo S. Almeida Hildo Rocha Cirne Azevedo-Filho Simultaneous Cranioplasty and External Ventricular Drain Implantation in Patients with Hydrocephalus: Case Series and Literature Review Brazilian Neurosurgery cranioplasty external ventricular drain post-traumatic hydrocephalus neurosurgery |
| title | Simultaneous Cranioplasty and External Ventricular Drain Implantation in Patients with Hydrocephalus: Case Series and Literature Review |
| title_full | Simultaneous Cranioplasty and External Ventricular Drain Implantation in Patients with Hydrocephalus: Case Series and Literature Review |
| title_fullStr | Simultaneous Cranioplasty and External Ventricular Drain Implantation in Patients with Hydrocephalus: Case Series and Literature Review |
| title_full_unstemmed | Simultaneous Cranioplasty and External Ventricular Drain Implantation in Patients with Hydrocephalus: Case Series and Literature Review |
| title_short | Simultaneous Cranioplasty and External Ventricular Drain Implantation in Patients with Hydrocephalus: Case Series and Literature Review |
| title_sort | simultaneous cranioplasty and external ventricular drain implantation in patients with hydrocephalus case series and literature review |
| topic | cranioplasty external ventricular drain post-traumatic hydrocephalus neurosurgery |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1730332 |
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