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Vychopen M, Schneider M, Borger V, et al. Complete hemispheric exposure vs. superior sagittal sinus sparing craniectomy: incidence of shear-bleeding and shunt-dependency. Eur J Trauma Emerg Surg. 2021;doi: 10.1007/s00068-021-01789-8.
Vychopen, M., Schneider, M., Borger, V., Schuss, P., Behning, C., Vatter, H., & Güresir, E. (2021). Complete hemispheric exposure vs. superior sagittal sinus sparing craniectomy: incidence of shear-bleeding and shunt-dependency. European journal of trauma and emergency surgery : official publication of the European Trauma Society, . https://doi.org/10.1007/s00068-021-01789-8
Vychopen, Martin, et al. "Complete hemispheric exposure vs. superior sagittal sinus sparing craniectomy: incidence of shear-bleeding and shunt-dependency." European journal of trauma and emergency surgery : official publication of the European Trauma Society vol. (2021). doi: https://doi.org/10.1007/s00068-021-01789-8
Vychopen M, Schneider M, Borger V, Schuss P, Behning C, Vatter H, Güresir E. Complete hemispheric exposure vs. superior sagittal sinus sparing craniectomy: incidence of shear-bleeding and shunt-dependency. Eur J Trauma Emerg Surg. 2021 Oct 04; doi: 10.1007/s00068-021-01789-8. Epub 2021 Oct 04. PMID: 34605961.
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Eur J Trauma Emerg Surg. 2021 Oct 04; doi: 10.1007/s00068-021-01789-8. Epub 2021 Oct 04.

Complete hemispheric exposure vs. superior sagittal sinus sparing craniectomy: incidence of shear-bleeding and shunt-dependency.

European journal of trauma and emergency surgery : official publication of the European Trauma Society

Martin Vychopen, Matthias Schneider, Valeri Borger, Patrick Schuss, Charlotte Behning, Hartmut Vatter, Erdem Güresir

Affiliations

  1. Department of Neurosurgery, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany. [email protected].
  2. Department of Neurosurgery, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany.
  3. Department of Medical Biometry, Informatics and Epidemiology, Universität Bonn, Institut für Medizinische Biometrie, Informatik und Epidemiologie (IMBIE), Bonn, Germany.

PMID: 34605961 DOI: 10.1007/s00068-021-01789-8

Abstract

PURPOSE: Decompressive hemicraniectomy (DC) has been established as a standard therapeutical procedure for raised intracranial pressure. However, the size of the DC remains unspecified. The aim of this study was to analyze size related complications following DC.

METHODS: Between 2013 and 2019, 306 patients underwent DC for elevated intracranial pressure at author´s institution. Anteroposterior and craniocaudal DC size was measured according to the postoperative CT scans. Patients were divided into two groups with (1) exposed superior sagittal sinus (SE) and (2) without superior sagittal sinus exposure (SC). DC related complications e.g. shear-bleeding at the margins of craniectomy and secondary hydrocephalus were evaluated and compared.

RESULTS: Craniectomy size according to anteroposterior diameter and surface was larger in the SE group; 14.1 ± 1 cm vs. 13.7 ± 1.2 cm, p = 0.003, resp. 222.5 ± 40 cm

CONCLUSIONS: Complete hemispheric exposure in terms of DC with SE was associated with significantly lower levels of iatrogenic shear-bleedings compared to a SC-surgical regime. Although we did not find significant outcome difference, our findings suggest aggressive craniectomy regimes including SE to constitute the surgical treatment strategy of choice for malignant intracranial pressure.

© 2021. The Author(s).

Keywords: Decompressive hemicraniectomy; Shear-bleeding; Size

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