| Autor: |
Aidinoff, Elena, Lehrer, Hiela, Gelernter, Ilana, Dayan, Ilil, Kfir, Adi, Front, Lilach, Oksamitny, Ana, Catz, Amiram |
| Předmět: |
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| Zdroj: |
Brain Impairment (CSIRO Publishing); Sep2024, Vol. 25 Issue 3, p1-9, 9p |
| Abstrakt: |
Background: Studies that have shown neurological improvement following cranioplasty (CP) after decompressive craniectomy (DC) in patients with unresponsive wakefulness syndrome (UWS) and minimally conscious state (MCS) did not include control groups. The aim of this study was to assess the justification of CP for these patients. Methods: Data were collected from medical records of inpatients with UWS and MCS admitted between 2002 and 2018. Results: Of the 144 participants (mean age 40 years, 76% males, 75% in UWS), 37% had CP following DC. The Loewenstein Communication Scale (LCS) gain was 12 ± 17 and 16 ± 17 for the control and study patients, respectively. The corresponding consciousness recovery rate (based on Coma Recovery Scale-Revised scores) was 51% and 53%, respectively. One-year survival rates were 0.80 and 0.93, and 5-year survival rates were 0.67 and 0.73, respectively. Mean outcome values were higher for the study group, but the differences between the groups did not reach statistical significance. Conclusions: The study did not demonstrate that CP increases brain recovery or survival. Nevertheless, it showed that CP did not decrease them either, and it did not increase complications rate. The findings, therefore, support offering CP to patients with UWS and MCS as CP does not increase risks and can achieve additional goals for these patients. Certain patients with reduced consciousness undergo an operation to remove a portion of the skull to relieve intracranial pressure. This study compared the outcomes of such patients with those of similar patients who later underwent an additional operation to repair the skull. The second operation, which restores cosmesis and has other advantages, did not decrease consciousness recovery or survival and did not increase the risk of complications; therefore, we concluded that it can be offered to these patients. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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