The Study Of Evidence Of Operative Opportunity In Traumatic Cranioplasty

ObjectiveTo observe the evidence of operative opportunity in traumatic cranioplasty.MethodsTo analyze 105 cases with skull defect retrospectively during January 2004 and December 2009 in the people's hospital of LiaoCheng of ShanDong province.All of the cases were randomly divided into three groups according to the degree of umbilication of decompression window which based on skull CT scan:light umbilication group is no more than 1cm, severe umbilication group is more than 2cm, between them is midrange group. Evaluate the time in mending skull defect, the change of neural function after operate, and the rate of complication. So as to observe the evidence of operative opportunity in traum-atic cranioplasty.ResultsAll of the 105 cases with skull defect,79 cases take cranioplasty in three months after decompressive craniectomy and 26 cases take cranioplasty after three months, the operate time of light and midrange umbilication group is much earlier than severe group.73 cases have benefits in neural function, the rate is 69.52%;26 case have complication after the operation of cranioplasty,incidence rate is 24.76%. The light umbilication group:the mean time of cranioplasty is 8±0.15 weeks after decompressive craniectomy, the neural function improved from cranioplasty is 32 cases, the rate is 82.05%,5 cases have complication, incidence rate is 12.82%.The midrange umbilication group:the mean time of cranioplasty is 9±0.45 weeks after decompressive craniectomy, the neural func-tion improved from cranioplasty is 26 cases, the rate is 76.47%,6 cases have complication, incidence rate is 17.65%.The severe umbilication group:the mean time of cranioplasty is 15±0.65 weeks after decompressive craniecto-my,the neural function improved from cranioplasty is 15 cases, the rate is 46.88%,13 cases have complication, incidence rate is 46.88%. The light and midrange umbilication group take better neural function improvement and have less complication.ConclusionsTake the change of decompression window umbilication as evidence for operative opportunity of cranioplasty is reliable and precise. Only take the change of time as evidence for operative opportunity of cranioplasty is limited and inaccurate. Traumatic cranioplasty need to be taken as early as possible once the internal cerebral pressure (ICP) is normal, decompression window is in light umbilication, operative incision is healing and vital sign is stable. It not only can relief spiritual and mental stress brought by skull defect, improve severe self-conscious symptom, but also stop even reverse the secondry brain injury, improve neural function, elevate quality of life,also reduce the incidence of some complication.