Osteoplastic Decompressive Craniotomy

Czech version

Authors: J. Mraček; M. Choc; Z. Mraček
Authors‘ workplace: Neurochirurgické oddělení FN Plzeň
Published in: Cesk Slov Neurol N 2007; 70/103(3): 290-293
Category: Short Communication

Overview

Decompressive craniotomy belongs to standard neurosurgical interventions in the therapy for the brain oedema. Decompression is usually carried out by osteoclastic decompressive craniotomy (craniectomy) followed later by necessary plasty of the bone defect. In the case of osteoplastic decompressive craniotomy a free bone plate elevated by the cerebral tissue expansion is left in place. After the oedema disappearance, the bone plate returns to its original position and is reattached. Therefore, cranioplasty need not be performed. There was analysed a ten-years´ set of 129 patients who had undergone osteoplastic decompressive craniotomy for the brain oedema under various pathological conditions (98× trauma, 22× vascular lesion, 8× tumor, 1× abscess). The patients´ outcome was evaluated using Karnovsky performance scale (more than 70–39%, 30–70–26%, less than 30–35%) and Glasgow outcome scale (5–19%, 4–20%, 3–26%, 2–13%, 1–22%). Osteoplastic decompressive craniotomy is an effective method of treating the brain oedema when the degree of expansion does not require a radical removal of the bone plate and, thus, further surgery – the bone defect plasty – is not needed.

Key words:
osteoplastic decompressive craniotomy – decompressive craniectomy – intracranial hypertension – brain oedema – cranioplasty

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