The impact of early cranioplasty on cerebral blood flow and metabolism and its correlation with neurological and cognitive outcome: Prospective multi-center study on 34 patients

Background: The main indications for cranial reconstruction following decompressive craniectomy at present are cerebral protection and the cosmetic repair. Many reports about neurological improvement after cranioplasty are now available in the literature; however, the underlying patho-physiological...

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Main Authors: Salvatore Chibbaro, M Fricia, F Vallee, K Beccaria, P Poczos, J Mateo, A Romano, S Ippolito, M Ippolito, J P Guichard, C Gobron, B George, E Vicaut
Format: Article
Language:English
Published: Thieme Medical Publishers, Inc. 2012-01-01
Series:Indian Journal of Neurosurgery
Subjects:
Online Access:http://www.ijns.in/article.asp?issn=2277-9167;year=2012;volume=1;issue=1;spage=17;epage=22;aulast=Chibbaro
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author Salvatore Chibbaro
M Fricia
F Vallee
K Beccaria
P Poczos
J Mateo
A Romano
S Ippolito
M Ippolito
J P Guichard
C Gobron
B George
E Vicaut
author_facet Salvatore Chibbaro
M Fricia
F Vallee
K Beccaria
P Poczos
J Mateo
A Romano
S Ippolito
M Ippolito
J P Guichard
C Gobron
B George
E Vicaut
author_sort Salvatore Chibbaro
collection DOAJ
description Background: The main indications for cranial reconstruction following decompressive craniectomy at present are cerebral protection and the cosmetic repair. Many reports about neurological improvement after cranioplasty are now available in the literature; however, the underlying patho-physiological mechanisms are still unknown. Materials and Methods: Thirty four patients undergoing decompressive craniectomy for severe head injury and early cranioplasty were prospectively studied. Clinical outcome was evaluated by GOS, FAB and MMSE, 3 days prior and 1 and 6 months after surgery; Trans-cranial Doppler and 18 FDG PET scan were also performed (to explore local and global brain hemodynamic and metabolic changes) 3 days prior to, and 30 days after cranial reconstruction. Results: Cranioplasty improved local and global cerebral brain perfusion (CBF) as well as brain metabolism in all 34 (100%) patients. Ninety-one % of patients showed also a clear and remarkable neuro-cognitive improvement tested by GOS, FAB and MMSE in the post-cranioplasty period. Conclusion: Cranial reconstruction has an effect upon local as well as global brain CBF and metabolism, constituting probably an essential factor influencing the final functional and especially cognitive outcome in a patient.
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spelling doaj.art-f75e7d1cc5424445a4d89c8de5e22c142022-12-21T19:06:16ZengThieme Medical Publishers, Inc.Indian Journal of Neurosurgery2277-91672012-01-0111172210.4103/2277-9167.94365The impact of early cranioplasty on cerebral blood flow and metabolism and its correlation with neurological and cognitive outcome: Prospective multi-center study on 34 patientsSalvatore ChibbaroM FriciaF ValleeK BeccariaP PoczosJ MateoA RomanoS IppolitoM IppolitoJ P GuichardC GobronB GeorgeE VicautBackground: The main indications for cranial reconstruction following decompressive craniectomy at present are cerebral protection and the cosmetic repair. Many reports about neurological improvement after cranioplasty are now available in the literature; however, the underlying patho-physiological mechanisms are still unknown. Materials and Methods: Thirty four patients undergoing decompressive craniectomy for severe head injury and early cranioplasty were prospectively studied. Clinical outcome was evaluated by GOS, FAB and MMSE, 3 days prior and 1 and 6 months after surgery; Trans-cranial Doppler and 18 FDG PET scan were also performed (to explore local and global brain hemodynamic and metabolic changes) 3 days prior to, and 30 days after cranial reconstruction. Results: Cranioplasty improved local and global cerebral brain perfusion (CBF) as well as brain metabolism in all 34 (100%) patients. Ninety-one % of patients showed also a clear and remarkable neuro-cognitive improvement tested by GOS, FAB and MMSE in the post-cranioplasty period. Conclusion: Cranial reconstruction has an effect upon local as well as global brain CBF and metabolism, constituting probably an essential factor influencing the final functional and especially cognitive outcome in a patient.http://www.ijns.in/article.asp?issn=2277-9167;year=2012;volume=1;issue=1;spage=17;epage=22;aulast=ChibbaroBrain cerebral brain perfusionbrain glucose metabolismcranioplastycognitive and functional outcomesyndrome of the sinking bone flap
spellingShingle Salvatore Chibbaro
M Fricia
F Vallee
K Beccaria
P Poczos
J Mateo
A Romano
S Ippolito
M Ippolito
J P Guichard
C Gobron
B George
E Vicaut
The impact of early cranioplasty on cerebral blood flow and metabolism and its correlation with neurological and cognitive outcome: Prospective multi-center study on 34 patients
Indian Journal of Neurosurgery
Brain cerebral brain perfusion
brain glucose metabolism
cranioplasty
cognitive and functional outcome
syndrome of the sinking bone flap
title The impact of early cranioplasty on cerebral blood flow and metabolism and its correlation with neurological and cognitive outcome: Prospective multi-center study on 34 patients
title_full The impact of early cranioplasty on cerebral blood flow and metabolism and its correlation with neurological and cognitive outcome: Prospective multi-center study on 34 patients
title_fullStr The impact of early cranioplasty on cerebral blood flow and metabolism and its correlation with neurological and cognitive outcome: Prospective multi-center study on 34 patients
title_full_unstemmed The impact of early cranioplasty on cerebral blood flow and metabolism and its correlation with neurological and cognitive outcome: Prospective multi-center study on 34 patients
title_short The impact of early cranioplasty on cerebral blood flow and metabolism and its correlation with neurological and cognitive outcome: Prospective multi-center study on 34 patients
title_sort impact of early cranioplasty on cerebral blood flow and metabolism and its correlation with neurological and cognitive outcome prospective multi center study on 34 patients
topic Brain cerebral brain perfusion
brain glucose metabolism
cranioplasty
cognitive and functional outcome
syndrome of the sinking bone flap
url http://www.ijns.in/article.asp?issn=2277-9167;year=2012;volume=1;issue=1;spage=17;epage=22;aulast=Chibbaro
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