Image Evaluation on the Effort and Effect of Craniectomy

• Main Authors: Furen Xiao, 蕭輔仁
• Other Authors: 翁昭旼
• Format: Others
• Language: en_US
• Published: 2011
• Online Access: http://ndltd.ncl.edu.tw/handle/17311770384335197120

博士 === 國立臺灣大學 === 醫學工程學研究所 === 99 === Craniectomy is one of the most common cranial surgeries. The object of this procedure is basically to provide an extra space for the swollen brain by removing part of the skull, and therefore reducing the intracranial pressure and avoiding secondary injuries to the brain. The most common indications of craniectomy are severe head injuries and large infarcts. Many studies showed positive effects of craniectomy for neurological outcomes, but there were some studies showing no effect. We propose some quantitative image parameters for evaluation of decompressive efforts and decompressive effects. The former includes the craniectomy volume and surface area. In addition to the computerized measurement, the craniectomy volume and area can also be estimated by simple formulas. It is so simple that the estimation of craniectomy volume or area should be considered a routine in every craniectomy study. The parameters for decompressive effects include the midline return, potential cranial capacity increment, and actual brain volume increment. These parameters also correlate with decompressive efforts and are actually functions of time. In addition to the computerized measurement, the midline return can be readily measured manually. We observed some correlation between these parameters and many clinical variables. They also correlated with the postoperative intracranial pressure and neurological outcome. Further studies should be done to clarify the clinical significance.