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01-03-2014 | Functional Neuroradiology

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

Authors: Silvio Sarubbo, Francesco Latini, Stefano Ceruti, Arturo Chieregato, Christopher d’Esterre, Ting-Yim Lee, Michele Cavallo, Enrico Fainardi

Published in: Neuroradiology | Issue 3/2014

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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Title: Temporal changes in CT perfusion values before and after cranioplasty in patients without symptoms related to external decompression: a pilot study
Authors: Silvio Sarubbo
Francesco Latini
Stefano Ceruti
Arturo Chieregato
Christopher d’Esterre
Ting-Yim Lee
Michele Cavallo
Enrico Fainardi
Publication date: 01-03-2014
Publisher: Springer Berlin Heidelberg
Published in: Neuroradiology / Issue 3/2014
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-014-1318-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

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

Abstract

Introduction

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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