Asymmetric optic nerve sheath diameter as an outcome factor following cranioplasty in patients harboring the 'syndrome of the trephined'
Decompressive craniectomy (DC) is gaining an increasing role in the neurosurgical treatment of intractable intracranial hypertension, but not without complications. A rare complication is the “syndrome of the trephined” (ST). It occurs when the forces of gravity overwhelm intracranial pressures, leading the brain to become sunken. Objective To determine the usefulness of asymmetric optic nerve sheath diameter (ONSD) as an outcome factor after cranioplasty. Method We followed-up 5 patients submitted to DC and diagnosed with ST. All were submitted to brain MRI to calculate the ONSD. Results Only two patients presented an asymmetric ONSD, being ONSD larger at the site of craniectomy. Surprisingly these patients had a marked neurological improvement after cranioplasty. They became independent a week after and statistically earlier than others. Conclusion It is presumed that the presence of an asymmetric ONSD in trephined patients is an independent factor of good outcome after cranioplasty.
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Academia Brasileira de Neurologia - ABNEURO
2013
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oai:scielo:S0004-282X20130013009632013-12-13Asymmetric optic nerve sheath diameter as an outcome factor following cranioplasty in patients harboring the 'syndrome of the trephined'Araujo Junior,Antonio Santos deArlant,Pedro AlbertoSalvestrini Jr,ArnaldoAltieri,Carlos EduardoSantos,Jasper GuimaraesPinto,Lauro FigueiraFazzito,Mirella MartinsLee,Hae WonGodoy,Luis Felipe de Souza decompressive craniectomy syndrome of the trephined optic nerve Decompressive craniectomy (DC) is gaining an increasing role in the neurosurgical treatment of intractable intracranial hypertension, but not without complications. A rare complication is the “syndrome of the trephined” (ST). It occurs when the forces of gravity overwhelm intracranial pressures, leading the brain to become sunken. Objective To determine the usefulness of asymmetric optic nerve sheath diameter (ONSD) as an outcome factor after cranioplasty. Method We followed-up 5 patients submitted to DC and diagnosed with ST. All were submitted to brain MRI to calculate the ONSD. Results Only two patients presented an asymmetric ONSD, being ONSD larger at the site of craniectomy. Surprisingly these patients had a marked neurological improvement after cranioplasty. They became independent a week after and statistically earlier than others. Conclusion It is presumed that the presence of an asymmetric ONSD in trephined patients is an independent factor of good outcome after cranioplasty. info:eu-repo/semantics/openAccessAcademia Brasileira de Neurologia - ABNEUROArquivos de Neuro-Psiquiatria v.71 n.12 20132013-12-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2013001300963en10.1590/0004-282X20130176 |
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Araujo Junior,Antonio Santos de Arlant,Pedro Alberto Salvestrini Jr,Arnaldo Altieri,Carlos Eduardo Santos,Jasper Guimaraes Pinto,Lauro Figueira Fazzito,Mirella Martins Lee,Hae Won Godoy,Luis Felipe de Souza |
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Araujo Junior,Antonio Santos de Arlant,Pedro Alberto Salvestrini Jr,Arnaldo Altieri,Carlos Eduardo Santos,Jasper Guimaraes Pinto,Lauro Figueira Fazzito,Mirella Martins Lee,Hae Won Godoy,Luis Felipe de Souza Asymmetric optic nerve sheath diameter as an outcome factor following cranioplasty in patients harboring the 'syndrome of the trephined' |
author_facet |
Araujo Junior,Antonio Santos de Arlant,Pedro Alberto Salvestrini Jr,Arnaldo Altieri,Carlos Eduardo Santos,Jasper Guimaraes Pinto,Lauro Figueira Fazzito,Mirella Martins Lee,Hae Won Godoy,Luis Felipe de Souza |
author_sort |
Araujo Junior,Antonio Santos de |
title |
Asymmetric optic nerve sheath diameter as an outcome factor following cranioplasty in patients harboring the 'syndrome of the trephined' |
title_short |
Asymmetric optic nerve sheath diameter as an outcome factor following cranioplasty in patients harboring the 'syndrome of the trephined' |
title_full |
Asymmetric optic nerve sheath diameter as an outcome factor following cranioplasty in patients harboring the 'syndrome of the trephined' |
title_fullStr |
Asymmetric optic nerve sheath diameter as an outcome factor following cranioplasty in patients harboring the 'syndrome of the trephined' |
title_full_unstemmed |
Asymmetric optic nerve sheath diameter as an outcome factor following cranioplasty in patients harboring the 'syndrome of the trephined' |
title_sort |
asymmetric optic nerve sheath diameter as an outcome factor following cranioplasty in patients harboring the 'syndrome of the trephined' |
description |
Decompressive craniectomy (DC) is gaining an increasing role in the neurosurgical treatment of intractable intracranial hypertension, but not without complications. A rare complication is the “syndrome of the trephined” (ST). It occurs when the forces of gravity overwhelm intracranial pressures, leading the brain to become sunken. Objective To determine the usefulness of asymmetric optic nerve sheath diameter (ONSD) as an outcome factor after cranioplasty. Method We followed-up 5 patients submitted to DC and diagnosed with ST. All were submitted to brain MRI to calculate the ONSD. Results Only two patients presented an asymmetric ONSD, being ONSD larger at the site of craniectomy. Surprisingly these patients had a marked neurological improvement after cranioplasty. They became independent a week after and statistically earlier than others. Conclusion It is presumed that the presence of an asymmetric ONSD in trephined patients is an independent factor of good outcome after cranioplasty. |
publisher |
Academia Brasileira de Neurologia - ABNEURO |
publishDate |
2013 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2013001300963 |
work_keys_str_mv |
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