A new improved method for assessing brain deformation after decompressive craniectomy.

<h4>Background</h4>Decompressive craniectomy (DC) is a surgical intervention used following traumatic brain injury to prevent or alleviate raised intracranial pressure. However the clinical effectiveness of the intervention remains in doubt. The location of the craniectomy (unilateral or...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Tim L Fletcher, Angelos G Kolias, Peter J Hutchinson, Michael P F Sutcliffe
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/0a182d56c7ee4a249da4394d369d7168
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:0a182d56c7ee4a249da4394d369d7168
record_format	dspace
spelling	oai:doaj.org-article:0a182d56c7ee4a249da4394d369d71682021-11-25T05:57:03ZA new improved method for assessing brain deformation after decompressive craniectomy.1932-620310.1371/journal.pone.0110408https://doaj.org/article/0a182d56c7ee4a249da4394d369d71682014-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0110408https://doaj.org/toc/1932-6203<h4>Background</h4>Decompressive craniectomy (DC) is a surgical intervention used following traumatic brain injury to prevent or alleviate raised intracranial pressure. However the clinical effectiveness of the intervention remains in doubt. The location of the craniectomy (unilateral or bifrontal) might be expected to change the brain deformation associated with the operation and hence the clinical outcome. As existing methods for assessing brain deformation have several limitations, we sought to develop and validate a new improved method.<h4>Methods</h4>Computed tomography (CT) scans were taken from 27 patients who underwent DC (17 bifrontal patients and 10 unilateral patients). Pre-operative and post-operative images were processed and registered to determine the change in brain position associated with the operation. The maximum deformation in the herniated brain, the change in volume and estimates of the craniectomy area were determined from the images. Statistical comparison was made using the Pearson's correlation coefficient r and a Welch's two-tailed T-test, with statistical significance reported at the 5% level.<h4>Results</h4>There was a reasonable correlation between the volume increase and the maximum brain displacement (r = 0.64), a low correlation between the volume increase and the craniectomy area (r = 0.30) and no correlation between the maximum displacement and the craniectomy area (r = -0.01). The maximum deformation was significantly lower (P = 0.023) in the bifrontal patients (mean = 22.5 mm) compared with the unilateral patients (mean = 29.8 mm). Herniation volume was significantly lower (P = 0.023) in bifrontal (mean = 50.0 ml) than unilateral patients (mean = 107.3 ml). Craniectomy area was not significantly different for the two craniectomy locations (P = 0.29).<h4>Conclusions</h4>A method has been developed to quantify changes in brain deformation due to decompressive craniectomy from CT images and allow comparison between different craniectomy locations. Measured displacement is a reasonable way to characterise volume changes.Tim L FletcherAngelos G KoliasPeter J HutchinsonMichael P F SutcliffePublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 10, p e110408 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Tim L Fletcher Angelos G Kolias Peter J Hutchinson Michael P F Sutcliffe A new improved method for assessing brain deformation after decompressive craniectomy.
description	<h4>Background</h4>Decompressive craniectomy (DC) is a surgical intervention used following traumatic brain injury to prevent or alleviate raised intracranial pressure. However the clinical effectiveness of the intervention remains in doubt. The location of the craniectomy (unilateral or bifrontal) might be expected to change the brain deformation associated with the operation and hence the clinical outcome. As existing methods for assessing brain deformation have several limitations, we sought to develop and validate a new improved method.<h4>Methods</h4>Computed tomography (CT) scans were taken from 27 patients who underwent DC (17 bifrontal patients and 10 unilateral patients). Pre-operative and post-operative images were processed and registered to determine the change in brain position associated with the operation. The maximum deformation in the herniated brain, the change in volume and estimates of the craniectomy area were determined from the images. Statistical comparison was made using the Pearson's correlation coefficient r and a Welch's two-tailed T-test, with statistical significance reported at the 5% level.<h4>Results</h4>There was a reasonable correlation between the volume increase and the maximum brain displacement (r = 0.64), a low correlation between the volume increase and the craniectomy area (r = 0.30) and no correlation between the maximum displacement and the craniectomy area (r = -0.01). The maximum deformation was significantly lower (P = 0.023) in the bifrontal patients (mean = 22.5 mm) compared with the unilateral patients (mean = 29.8 mm). Herniation volume was significantly lower (P = 0.023) in bifrontal (mean = 50.0 ml) than unilateral patients (mean = 107.3 ml). Craniectomy area was not significantly different for the two craniectomy locations (P = 0.29).<h4>Conclusions</h4>A method has been developed to quantify changes in brain deformation due to decompressive craniectomy from CT images and allow comparison between different craniectomy locations. Measured displacement is a reasonable way to characterise volume changes.
format	article
author	Tim L Fletcher Angelos G Kolias Peter J Hutchinson Michael P F Sutcliffe
author_facet	Tim L Fletcher Angelos G Kolias Peter J Hutchinson Michael P F Sutcliffe
author_sort	Tim L Fletcher
title	A new improved method for assessing brain deformation after decompressive craniectomy.
title_short	A new improved method for assessing brain deformation after decompressive craniectomy.
title_full	A new improved method for assessing brain deformation after decompressive craniectomy.
title_fullStr	A new improved method for assessing brain deformation after decompressive craniectomy.
title_full_unstemmed	A new improved method for assessing brain deformation after decompressive craniectomy.
title_sort	new improved method for assessing brain deformation after decompressive craniectomy.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/0a182d56c7ee4a249da4394d369d7168
work_keys_str_mv	AT timlfletcher anewimprovedmethodforassessingbraindeformationafterdecompressivecraniectomy AT angelosgkolias anewimprovedmethodforassessingbraindeformationafterdecompressivecraniectomy AT peterjhutchinson anewimprovedmethodforassessingbraindeformationafterdecompressivecraniectomy AT michaelpfsutcliffe anewimprovedmethodforassessingbraindeformationafterdecompressivecraniectomy AT timlfletcher newimprovedmethodforassessingbraindeformationafterdecompressivecraniectomy AT angelosgkolias newimprovedmethodforassessingbraindeformationafterdecompressivecraniectomy AT peterjhutchinson newimprovedmethodforassessingbraindeformationafterdecompressivecraniectomy AT michaelpfsutcliffe newimprovedmethodforassessingbraindeformationafterdecompressivecraniectomy
_version_	1718414322984550400

A new improved method for assessing brain deformation after decompressive craniectomy.

Ejemplares similares