Simultaneous Cranioplasty and External Ventricular Drain Implantation in Patients with Hydrocephalus: Case Series and Literature Review
| Autor: | Hildo Azevedo-Filho, Nivaldo S. Almeida, Kauê Franke, John Anderson da Silva Rocha, Glaudir Donato Pinto Júnior, Pierre Vansant Oliveira Eugenio, João Pedro Medeiros, Juan Pablo Borges Rodrigues Maricevich, Lívio Pereira de Macêdo, Arlindo Ugulino Netto |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
RD1-811 medicine.medical_treatment Context (language use) external ventricular drain 03 medical and health sciences 0302 clinical medicine Cerebrospinal fluid medicine post-traumatic hydrocephalus neurosurgery Intracranial pressure business.industry medicine.disease Cranioplasty Hydrocephalus Surgery 030220 oncology & carcinogenesis cranioplasty Medicine Decompressive craniectomy Neurology (clinical) Neurosurgery business 030217 neurology & neurosurgery External ventricular drain |
| Zdroj: | Brazilian Neurosurgery, Vol 40, Iss 04, Pp e297-e302 (2021) |
| ISSN: | 2359-5922 0103-5355 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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