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Temporal changes in CT perfusion values before and after cranioplasty in patients without symptoms related to external decompression: a pilot study

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Abstract

Introduction

Little is known about hemodynamic disturbances affecting cerebral hemispheres in traumatic brain injury (TBI) after cranioplasty.

Methods

We prospectively investigated six stable TBI patients who underwent cranioplasty more than 90 days after effective decompressive craniectomy. Computerized tomography perfusion (CTP) studies and evaluation of clinical outcome were performed for each patient before cranioplasty and at 7 days and 3 months after surgery. Cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) were measured in multiple cortical circular regions positioned in cranioplasty-treated and contralateral hemispheres.

Results

Neither complications associated with cranioplasty nor changes in outcome were observed. On the treated side, CBF and CBV values were higher before and 7 days after cranioplasty than at 3 months after surgery, whereas MTT values were lower at 7 days than at 3 months after surgical treatment.

Conclusions

Our results indicate that cortical perfusion progressively declines in the cranioplasty treated hemisphere but remains stable in the contralateral hemisphere after surgery and suggest that CTP can represent a promising tool for a longitudinal analysis of hemodynamic abnormalities occurring in TBI patients after cranioplasty. In addition, these data imply a possible role of cranioplasty in restoring flow to meet the prevailing metabolic demand.

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Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Neurosurgery Unit, Department of Neurosciences, “S. Chiara” Hospital, APSS Trento, Trento, Italy

    Silvio Sarubbo

  2. Department of Medical and Surgical Sciences of Communication and Behavior, Clinics of Neurology, “S. Anna” University Hospital, Ferrara, Italy

    Silvio Sarubbo

  3. Neurosurgery Unit, Department of Neuroscience and Rehabilitation, “S. Anna” University Hospital, Ferrara, Italy

    Francesco Latini & Michele Cavallo

  4. Neuroradiology Unit, Department of Neuroscience and Rehabilitation, “S. Anna” University Hospital, Ferrara, Italy

    Stefano Ceruti & Enrico Fainardi

  5. Neurocritical Care Unit, Department of Neuroscience, “Careggi” University Hospital, Firenze, Italy

    Arturo Chieregato

  6. Foothills Medical Centre, University of Calgary, Calgary, Alberta, Canada

    Christopher d’Esterre

  7. Imaging Research Lab, Robarts Research Institute, Western Ontario University, London, Ontario, Canada

    Christopher d’Esterre & Ting-Yim Lee

  8. Imaging program, Lawson Health Research Institute, Western Ontario University, London, Ontario, Canada

    Ting-Yim Lee

  9. Unità Operativa di Neuroradiologia, Dipartimento di Neuroscienze, Azienda Ospedaliera Universitaria, Arcispedale S. Anna, Cona, Ferrara, 44124, Italy

    Enrico Fainardi

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  1. Silvio Sarubbo
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Correspondence to Enrico Fainardi.

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Sarubbo, S., Latini, F., Ceruti, S. et al. Temporal changes in CT perfusion values before and after cranioplasty in patients without symptoms related to external decompression: a pilot study. Neuroradiology 56, 237–243 (2014). https://doi.org/10.1007/s00234-014-1318-2

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  • DOI: https://doi.org/10.1007/s00234-014-1318-2

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