Asymmetric optic nerve sheath diameter as an outcome factor following cranioplasty in patients harboring the 'syndrome of the trephined'
| Autor: | Antonio Santos de Araujo Junior, Pedro Alberto Arlant, Arnaldo Salvestrini Jr, Carlos Eduardo Altieri, Jasper Guimaraes Santos, Lauro Figueira Pinto, Mirella Martins Fazzito, Hae Won Lee, Luis Felipe de Souza Godoy |
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| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: | |
| Zdroj: | Arquivos de Neuro-Psiquiatria, Vol 71, Iss 12, Pp 963-966 (2013) |
| Druh dokumentu: | article |
| ISSN: | 1678-4227 0004-282X |
| DOI: | 10.1590/0004-282X20130176 |
| Popis: | Decompressive craniectomy (DC) is gaining an increasing role in the neurosurgical treatment of intractable intracranial hypertension, but not without complications. A rare complication is the “syndrome of the trephined” (ST). It occurs when the forces of gravity overwhelm intracranial pressures, leading the brain to become sunken. Objective To determine the usefulness of asymmetric optic nerve sheath diameter (ONSD) as an outcome factor after cranioplasty. Method We followed-up 5 patients submitted to DC and diagnosed with ST. All were submitted to brain MRI to calculate the ONSD. Results Only two patients presented an asymmetric ONSD, being ONSD larger at the site of craniectomy. Surprisingly these patients had a marked neurological improvement after cranioplasty. They became independent a week after and statistically earlier than others. Conclusion It is presumed that the presence of an asymmetric ONSD in trephined patients is an independent factor of good outcome after cranioplasty. |
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