The relationship between intracranial pressure and neurocognitive function before and after the repair of a skull injury

You probably want to know about this if you had a skull flap removed to reduce pressure.

The relationship between intracranial pressure and neurocognitive function before and after the repair of a skull injury

J. HE

1

, L.-L. CHEN

2

, D.-K. SUN

1

, H.-T. WANG

1

, J.-J. WANG

1

, X. ZHAI

3

1

Neurosurgery Ward 2, Linyi City Yishui Central Hospital, Linyi, Shandong, P.R. China

2

Clinical Laboratory, Linyi City Yishui Central Hospital, Linyi, Shandong, P.R. China

3

Department of Neurological Surgery Unit 1, the First Affiliated Hospital of Liaoning Medical

University, Jinzhou, Liaoning, P.R. China

Abstract.

–

OBJECTIVE:

This study examines the relationship between intracranial pressure (ICP) changes after skull injury repair and neurocognitive function before and after the repair.

PATIENTS AND METHODS:

Sixty patients undergoing skull injury repair participated in the study. A non-invasive detection analyzer was used to detect the ICP 2 days before operation, 10 days after the operation and one month after the operation in all patients. Additionally, the mean cerebral blood flow velocities (MV) in the internal carotid and the medial cerebral arteries were detected using a transcranial Doppler ultrasound (TCD). The neurological and cognitive functions were assessed using the NIHSS and the MMSE scales, respectively. And finally, an ELISA assay was used to detect the plasma insulin-like growth factor (IGF)-1 and β-amyloid peptide (Aβ

) levels.

RESULTS :

The results showed that all parameters studied improved significantly and continuously after surgery.

CONCLUSIONS:

We suggest that the improvement in the ICP values and the neurocognitive functions are related to the resulting decreased expression levels of IGF-1 and Aβ after the repair.

One Versus Double Burr Holes for Treating Chronic Subdural Hematoma Meta-Analysis

For you patients that need part of your skull removed, would you rather have one or two holes in your head? Although I doubt you will have any say as your doctor does this.
http://cjns.metapress.com/content/1030477136x207l6/?id=1030477136X207L6

Abstract

Objective and Design: There is controversy among neurosurgeons regarding whether double burr hole craniostomy (DBHC) is better than single burr hole craniostomy (SBHC) in the treatment of chronic subdural hematoma (CSH), in terms of having a lower revision rate. In order to compare the revision rates after SBHC versus DBHC, we performed a meta-analysis of the available studies in the literature. Materials and Methods: Multiple electronic health databases were searched to identify all the studies published between 1966 and December 2010 that compared SBHC and DBHC. Data were processed in Review Manager 5.0.18. Effect sizes were expressed in pooled odds ratio (OR) estimates, and due to heterogeneity between studies we used random effect of the inverse variance weighted method to perform the meta-analysis. Results: Five observational retrospective cohort studies were identified: four published studies and one unpublished, describing the outcomes of 355 DBHC and 358 SBHC to evacuate 713 CSH in 631 patients. Meta-analysis showed that there was no significant difference in the revision rates between double burr hole craniostomy and single burr hole craniostomy when performed to evacuate CSH. Pooled odds ratio for all the studies was 0.62 (95% confidence interval 0.26 - 1.46). Conclusions: The results of this meta-analysis suggest that SBHC is as good as DBHC in evacuating chronic subdural hematoma and is not associated with a higher revision rate compared to DBHC.