Cerebrospinal fluid dynamics disorder after decompressive craniectomy

doi:10.3877/cma.j.issn.2095-9141.2017.03.013

Abstract

Abstract:

Continuous pulsation of cerebrospinal fluid (CSF) is impaired after decompressive craniectomy (DC), inducing disturbances of CSF absorption and distribution, consequently, neurological symptoms, which are called CSF dynamics disorders. acrrodingThey are classified into for types: syndrome of the trephined (SoT), paradoxical herniation, hydrocephalus and subdural collection of fluid. SoT is indentified by neurological deficits after DC, paradoxical herniation is an aggravating form of syndrome of SoT, commonly in connection with CSF drainage and excessive dehydration. Hydrocephalus and subdural collection of fluid, are common consequences after DC. Cranioplasty is the most preferred and definitive therapy of above four complications, impropriate drainage towards CSF distribution abnormality will worsen the condition, causing serious consequences.

Key words: Cerebrospinal fluid dynamics disorder, Paradoxical herniation, Hydrocephalus, Subdural effusion, Decompressive craniectomy

Yi Feng, Likun Yang, Yuhai Wang. Cerebrospinal fluid dynamics disorder after decompressive craniectomy[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2017, 03(03): 179-184.

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?	创伤性硬膜下积液	创伤性硬膜下渗出
形成机制	蛛网膜撕裂、渗透性增加	新生包膜和血管的渗漏
与脑脊液的交通	直接	孤立
蛋白含量	和CSF一样低	比CSF高
CT密度	低	高
组织形态	正常软脑膜出现破口	新生包膜
脑池造影	造影剂聚集	无造影剂进入
MR或CT增强	不增强	增强

?	创伤性硬膜下积液	创伤性硬膜下渗出
形成机制	蛛网膜撕裂、渗透性增加	新生包膜和血管的渗漏
与脑脊液的交通	直接	孤立
蛋白含量	和CSF一样低	比CSF高
CT密度	低	高
组织形态	正常软脑膜出现破口	新生包膜
脑池造影	造影剂聚集	无造影剂进入
MR或CT增强	不增强	增强

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