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KMID : 0857020050200010095
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Kosin Medical Journal
2005 Volume.20 No. 1 p.95 ~ p.100
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The Role of Decompressive Craniectomy in The Development of Shunt-Dependent Hydrocephalus.-Clinical Article-
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Jeon Byung-Chan
Seung Won-Bae
Kim Young-Soo
Lee Chang-Sik
Chun Tae-Sang
Kim Nam-Kyu
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Abstract
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Objective: Decompressive craniectomy is well known method of surgical treatment for excessive increment of intracranial pressure by intracerebral lesion. It has been reported that craniectomy after head trauma contributes to the development of hydorcephalus. But, there are no reports about it’s role in intracranial aneurysm and brain tumor. This study is designed to evaluate the role of decompressive craniectomy in the development of hydrocephalus in trauma, aneurysm, and tumor surgery.
Methods: Study of the 1264 patients with head trauma, aneurysm, and tumor between Jan. 1997 and Dec. 2001 was made retrospectively by reviewing their medical record. The incidence of shunt dependent hydrocephalus was evaluated in trauma, aneurysm, and tumor patients with or without decompressive craniectomy, and anlysed it with statistically.
Results: Shunt-dependent hydrocephalus was developed in 10 (2.7%) fo 359 patients with trauma, 24 (6.9%) of 347 with subarachnoid hemorrhage by aneurysaml rupture, and 9 (1.6%) of 558 with brain tumor. After decompressive craniectomy, it was developed in 6 (185) of 33 patients (p＜0.01), 7 (63.6%) of 11 (p＜0.01), and 3 (42.8%) of 7 (p＜0.01), respectively.
Conclusion: These results suggest that decompressive craniectomy act as a facilitating factor, not a causing factor in the development of shunt-dependent hydrocephalus. Scalp sagging and hydrodynamic change of cerebrospinal fluid circulation may play a primary role.
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KEYWORD
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Decompressive craniectomy, Hydrocephalus, Trauma, Tumor, Aneurysm
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