Simultaneous Cranioplasty and External Ventricular Drain Implantation in Patients with Hydrocephalus: Case Series and Literature Review

Introduction The increase in intracranial pressure (ICP) is a neurological complication resulting from numerous pathologies that affect the brain and its compartments. Therefore, decompressive craniectomy (DC) is an alternative adopted to reduce ICP in emergencies, especially in cases refractory to...

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Autores principales:	Lívio Pereira de Macêdo, Arlindo Ugulino Netto, Kauê Franke, Pierre Vansant Oliveira Eugenio, John Anderson da Silva Rocha, Glaudir Donato Pinto Júnior, João Pedro Maia Medeiros, Juan Pablo Borges Rodrigues Maricevich, Nivaldo S. Almeida, Hildo Rocha Cirne Azevedo-Filho
Formato:	article
Lenguaje:	EN
Publicado:	Thieme Revinter Publicações Ltda. 2021
Materias:	cranioplasty external ventricular drain post-traumatic hydrocephalus neurosurgery Medicine R Surgery RD1-811
Acceso en línea:	https://doaj.org/article/b49a296001dc47ce9a5a38aa4c67cc85
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spelling	oai:doaj.org-article:b49a296001dc47ce9a5a38aa4c67cc852021-11-27T00:19:21ZSimultaneous Cranioplasty and External Ventricular Drain Implantation in Patients with Hydrocephalus: Case Series and Literature Review0103-53552359-592210.1055/s-0041-1730332https://doaj.org/article/b49a296001dc47ce9a5a38aa4c67cc852021-07-01T00:00:00Zhttp://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1730332https://doaj.org/toc/0103-5355https://doaj.org/toc/2359-5922Introduction The increase in intracranial pressure (ICP) is a neurological complication resulting from numerous pathologies that affect the brain and its compartments. Therefore, decompressive craniectomy (DC) is an alternative adopted to reduce ICP in emergencies, especially in cases refractory to clinical therapies, in favor of patient survival. However, DC is associated with several complications, including hydrocephalus (HC). The present study presents the results of an unusual intervention to this complication: the implantation of an external ventricular drain (EVD) in the intraoperative period of cranioplasty (CP). Methods Patients of both genders who presented with HC and externalization of the brain through the cranial vault after decompressive hemicraniectomy and underwent EVD implantation, to allow the CP procedure, in the same surgical procedure, were included. Results Five patients underwent DC due to a refractory increase in ICP, due to automobile accidents, firearm projectiles, falls from stairs, and ischemic strokes. All evolved with HC. There was no uniform time interval between DC and CP. The cerebrospinal fluid (CSF) was drained according to the need for correction of cerebral herniation in each patient, before undergoing cranioplasty. All patients progressed well, without neurological deficits in the immediate postoperative period. Conclusion There are still several uncertainties about the management of HC resulting from DC. In this context, other CP strategies simultaneous to the drainage of CSF, not necessarily related to ventriculoperitoneal shunt (VPS), should be considered and evaluated more deeply, in view of the verification of efficacy in procedures of this scope, such as the EVD addressed in this study.Lívio Pereira de MacêdoArlindo Ugulino NettoKauê FrankePierre Vansant Oliveira EugenioJohn Anderson da Silva RochaGlaudir Donato Pinto JúniorJoão Pedro Maia MedeirosJuan Pablo Borges Rodrigues MaricevichNivaldo S. AlmeidaHildo Rocha Cirne Azevedo-FilhoThieme Revinter Publicações Ltda.articlecranioplastyexternal ventricular drainpost-traumatic hydrocephalusneurosurgeryMedicineRSurgeryRD1-811ENBrazilian Neurosurgery, Vol 40, Iss 04, Pp e297-e302 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	cranioplasty external ventricular drain post-traumatic hydrocephalus neurosurgery Medicine R Surgery RD1-811
spellingShingle	cranioplasty external ventricular drain post-traumatic hydrocephalus neurosurgery Medicine R Surgery RD1-811 Lívio Pereira de Macêdo Arlindo Ugulino Netto Kauê Franke Pierre Vansant Oliveira Eugenio John Anderson da Silva Rocha Glaudir Donato Pinto Júnior João Pedro Maia Medeiros Juan Pablo Borges Rodrigues Maricevich Nivaldo S. Almeida Hildo Rocha Cirne Azevedo-Filho Simultaneous Cranioplasty and External Ventricular Drain Implantation in Patients with Hydrocephalus: Case Series and Literature Review
description	Introduction The increase in intracranial pressure (ICP) is a neurological complication resulting from numerous pathologies that affect the brain and its compartments. Therefore, decompressive craniectomy (DC) is an alternative adopted to reduce ICP in emergencies, especially in cases refractory to clinical therapies, in favor of patient survival. However, DC is associated with several complications, including hydrocephalus (HC). The present study presents the results of an unusual intervention to this complication: the implantation of an external ventricular drain (EVD) in the intraoperative period of cranioplasty (CP). Methods Patients of both genders who presented with HC and externalization of the brain through the cranial vault after decompressive hemicraniectomy and underwent EVD implantation, to allow the CP procedure, in the same surgical procedure, were included. Results Five patients underwent DC due to a refractory increase in ICP, due to automobile accidents, firearm projectiles, falls from stairs, and ischemic strokes. All evolved with HC. There was no uniform time interval between DC and CP. The cerebrospinal fluid (CSF) was drained according to the need for correction of cerebral herniation in each patient, before undergoing cranioplasty. All patients progressed well, without neurological deficits in the immediate postoperative period. Conclusion There are still several uncertainties about the management of HC resulting from DC. In this context, other CP strategies simultaneous to the drainage of CSF, not necessarily related to ventriculoperitoneal shunt (VPS), should be considered and evaluated more deeply, in view of the verification of efficacy in procedures of this scope, such as the EVD addressed in this study.
format	article
author	Lívio Pereira de Macêdo Arlindo Ugulino Netto Kauê Franke Pierre Vansant Oliveira Eugenio John Anderson da Silva Rocha Glaudir Donato Pinto Júnior João Pedro Maia Medeiros Juan Pablo Borges Rodrigues Maricevich Nivaldo S. Almeida Hildo Rocha Cirne Azevedo-Filho
author_facet	Lívio Pereira de Macêdo Arlindo Ugulino Netto Kauê Franke Pierre Vansant Oliveira Eugenio John Anderson da Silva Rocha Glaudir Donato Pinto Júnior João Pedro Maia Medeiros Juan Pablo Borges Rodrigues Maricevich Nivaldo S. Almeida Hildo Rocha Cirne Azevedo-Filho
author_sort	Lívio Pereira de Macêdo
title	Simultaneous Cranioplasty and External Ventricular Drain Implantation in Patients with Hydrocephalus: Case Series and Literature Review
title_short	Simultaneous Cranioplasty and External Ventricular Drain Implantation in Patients with Hydrocephalus: Case Series and Literature Review
title_full	Simultaneous Cranioplasty and External Ventricular Drain Implantation in Patients with Hydrocephalus: Case Series and Literature Review
title_fullStr	Simultaneous Cranioplasty and External Ventricular Drain Implantation in Patients with Hydrocephalus: Case Series and Literature Review
title_full_unstemmed	Simultaneous Cranioplasty and External Ventricular Drain Implantation in Patients with Hydrocephalus: Case Series and Literature Review
title_sort	simultaneous cranioplasty and external ventricular drain implantation in patients with hydrocephalus: case series and literature review
publisher	Thieme Revinter Publicações Ltda.
publishDate	2021
url	https://doaj.org/article/b49a296001dc47ce9a5a38aa4c67cc85
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Simultaneous Cranioplasty and External Ventricular Drain Implantation in Patients with Hydrocephalus: Case Series and Literature Review

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