Effects of Early and Late Cranioplasty on Neurocognitive Outcome and Cerebral Glucose Metabolism using PET Scan - A Comparative Study.

IF 0.9 3区医学 Q4 NEUROSCIENCES

Neurology India Pub Date : 2024-09-01 Epub Date: 2024-10-19 DOI:10.4103/neurol-india.ni_906_22

Vivek Sharma, Venkata Vemula Rameshchandra, Bodapati Chandramouliswara Prasad, Rinu Dwivedi

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Abstract

Background: Brain protection and cosmetic aspects are the major indications of cranioplasty (CP) after decompressive craniectomy. CP can avoid the recurrence of brain damage, achieve the plastic effect, protect the patient from seizures, and relieve the syndrome of trephine.

Materials and methods: This was a prospective, observational study done over a period of 2 years from April 2017 to April 2019 in the Department of Neurosurgery at Sri Venkateswara Institute of Medical Sciences (SVIMS), Tirupati. Patients of age group 20-60 years who underwent CP after decompressive craniectomy for traumatic brain injury or cerebrovascular accidents with refractory intracranial hypertension were included. The study population was divided into two groups: early and late CP groups. Neurocognitive assessment was done 72 h before and 3 months after CP by mini-mental state examination (MMSE), Glasgow outcome score (GOS), and PGI battery of brain dysfunction (PGIBBD) scores. Cerebral glucose metabolism was assessed by 18F-FDG PET scan.

Results: In both early and late CP groups, there was a highly significant difference between the mean pre- and postoperative values of MMSE, GOS, and PGIBBD, suggesting significant improvement in neurocognitive parameters of patients postoperatively. There was no significant difference between early and late CP groups for mean standard uptake values (SUVs) on PET scan for both affected (P-value- 0.40) and nonaffected (P-value- 0.30) sides.

Conclusion: CP improves the cerebral metabolism and neurocognitive outcome, weather it is done early or late.

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使用正电子发射计算机断层扫描早期和晚期颅骨成形术对神经认知结果和脑葡萄糖代谢的影响 - 一项比较研究。

背景：脑保护和美容是颅骨减压术后颅骨成形术（CP）的主要适应症。CP可以避免脑损伤复发，达到塑形效果，保护患者免受癫痫发作，缓解穿刺综合征：这是一项前瞻性观察研究，自 2017 年 4 月至 2019 年 4 月在蒂鲁帕蒂斯里兰卡文卡特斯瓦拉医学科学研究所（SVIMS）神经外科进行，为期 2 年。研究对象包括因脑外伤或脑血管意外导致的难治性颅内高压而接受颅骨减压术后CP的20-60岁年龄组患者。研究对象分为两组：早期 CP 组和晚期 CP 组。分别在CP前72小时和CP后3个月进行神经认知评估，包括迷你精神状态检查（MMSE）、格拉斯哥结果评分（GOS）和PGI脑功能障碍电池（PGIBBD）评分。18F-FDG PET 扫描评估了脑葡萄糖代谢：在早期和晚期 CP 组中，术前和术后的 MMSE、GOS 和 PGIBBD 平均值之间存在非常显著的差异，这表明术后患者的神经认知指标得到了显著改善。CP早期组和CP晚期组患者PET扫描患侧（P-value- 0.40）和非患侧（P-value- 0.30）的平均标准摄取值（SUVs）无明显差异：结论：无论 CP 进行得早或晚，都能改善脑代谢和神经认知结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neurology India 医学-神经科学

CiteScore

1.60

自引率

70.40%

发文量

434

审稿时长

2 months

期刊介绍： Neurology India (ISSN 0028-3886) is Bi-monthly publication of Neurological Society of India. Neurology India, the show window of the progress of Neurological Sciences in India, has successfully completed 50 years of publication in the year 2002. ‘Neurology India’, along with the Neurological Society of India, has grown stronger with the passing of every year. The full articles of the journal are now available on internet with more than 20000 visitors in a month and the journal is indexed in MEDLINE and Index Medicus, Current Contents, Neuroscience Citation Index and EMBASE in addition to 10 other indexing avenues. This specialty journal reaches to about 2000 neurologists, neurosurgeons, neuro-psychiatrists, and others working in the fields of neurology.