Journal article
Volume of Brain Herniation in Patients with Ischemic Stroke After Decompressive Craniectomy
World neurosurgery, Vol.96, pp.101-106
12/2016
DOI: 10.1016/j.wneu.2016.08.095
PMID: 27591100
Abstract
Decompressive craniectomy procedures are performed in patients with malignant intracranial hypertension. A bone flap is removed to relieve pressure. Later, a second operation is performed to reconstruct the skull after brain swelling has resolved. This surgical treatment would be improved if it were possible to perform a single operation that decompressed the brain acutely and eliminated the need for a second operation. To design a device and procedure that achieve this objective, it is essential to understand how the brain swells after a craniectomy procedure.
We identified 20 patients with ischemic stroke who underwent a decompressive hemicraniectomy operation. Skull defect morphology and postoperative brain swelling were measured using computed tomography scan data. Additional intracranial volume created by placing a hypothetical cranial plate implant offset from the skull surface by 5 mm was measured for each patient.
The average craniectomy area and brain herniation volume was 9999 ± 1283 mm2 and 30.48 ± 23.56 mL, respectively. In all patients, the additional volume created by this hypothetical implant exceeded the volume of brain herniation observed.
These findings show that a cranial plate with a 5-mm offset accommodates the brain swelling that occurs in this patient population.
Details
- Title: Subtitle
- Volume of Brain Herniation in Patients with Ischemic Stroke After Decompressive Craniectomy
- Creators
- Kirsten E Stoner - Department of Biomedical Engineering, University of Iowa, Seamans Center for the Engineering Arts and Sciences, Iowa City, Iowa, USAKingsley O Abode-Iyamah - Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USANicole M Grosland - Department of Biomedical Engineering, University of Iowa, Seamans Center for the Engineering Arts and Sciences, Iowa City, Iowa, USAMatthew A Howard - Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
- Resource Type
- Journal article
- Publication Details
- World neurosurgery, Vol.96, pp.101-106
- DOI
- 10.1016/j.wneu.2016.08.095
- PMID
- 27591100
- NLM abbreviation
- World Neurosurg
- ISSN
- 1878-8750
- eISSN
- 1878-8769
- Publisher
- Elsevier Inc
- Language
- English
- Date published
- 12/2016
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Neurology; Iowa Neuroscience Institute; Orthopedics and Rehabilitation; Injury Prevention Research Center; Neurosurgery; Otolaryngology
- Record Identifier
- 9984013117102771
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