The impact of cranioplasty on neurological function

Abstract Objectives. To assess changes in neurological function after cranioplasty. Methods. Functional and neurocognitive assessments including activities of daily living assessment, functional independence measure (FIM) and the Cognitive assessment report (COGNISTAT) were conducted on all patients...

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Bibliographic Details
Published in:British journal of neurosurgery 2013-10, Vol.27 (5), p.636-641
Main Authors: Honeybul, Stephen, Janzen, Courtney, Kruger, Kate, Ho, Kwok M.
Format: Article
Language:English
Subjects:
Activities of Daily Living
Adult
Brain damage
Brain Diseases - physiopathology
Brain Diseases - surgery
Brain Injuries - physiopathology
Brain Injuries - surgery
Cognition & reasoning
Cognition Disorders - etiology
Cognition Disorders - physiopathology
Convulsions & seizures
cranioplasty
decompressive craniectomy
Decompressive Craniectomy - adverse effects
Female
Humans
Intracranial Hemorrhages - physiopathology
Intracranial Hemorrhages - surgery
Male
Middle Aged
Nervous System Diseases - etiology
Nervous System Diseases - physiopathology
Neurologic Examination
Neurosurgery
Postoperative Complications - etiology
Postoperative Complications - physiopathology
Prospective Studies
Recovery of Function
Skull - surgery
Stroke - physiopathology
Stroke - surgery
syndrome of trephined
Tomography, X-Ray Computed
traumatic brain injury
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Summary:Abstract Objectives. To assess changes in neurological function after cranioplasty. Methods. Functional and neurocognitive assessments including activities of daily living assessment, functional independence measure (FIM) and the Cognitive assessment report (COGNISTAT) were conducted on all patients within 72 h before and 7 days after cranioplasty. A change in the total FIM score of 2 points was taken to be clinically significant. Results. Assessments were performed on 25 patients. The functional status was unchanged in eighteen patients (72%), four patients (16%) demonstrated a significant improvement and three patients (12%) deteriorated significantly. Those with deterioration after cranioplasty had some forms of complications including pneumocephalus or seizure. After excluding the three patients who had immediate medical or surgical complications after surgery, there was a mild overall improvement in the mean FIM score (2.1, 95% confidence interval 0.1-4.3, p = 0.049), mainly due to an improvement in their motor function. Conclusions. A small but significant number of patients appear to improve clinically following cranioplasty. The so-called syndrome of the trephined may be more common than had been previously appreciated.
ISSN:0268-8697
1360-046X
DOI:10.3109/02688697.2013.817532