Analysis of Causes of Complications and Prognostic Factors After Titanium Mesh Ultra-Early Cranioplasty Following Decompressive Craniectomy for Craniocerebral Trauma

Abstract

PurposeTo explore the complications and prognostic factors after titanium mesh ultra-early cranioplasty (CP) after decompressive craniectomy (DC) for craniocerebral trauma. MethodFrom January 2020 to November 2022, 44 patients with craniocerebral trauma who needed ultra-early-CP after DC were collected. The basic data of NIHSS, GCS, mRS and MoCA scores of patients were collected, and the complications and prognosis of patients 3 months after operation were collected. Multivariate Logistic regression was used to analyze the prognostic factors. ResultsCompared with preoperative, the postoperative NIHSS score of patients with ultra-early-CP decreased, the postoperative GCS score increased, the postoperative mRS score decreased (P<0.05), and the postoperative MoCA score was higher. Postoperative complications occurred in 42 patients with ultra-early-CP. There were 37 complications, including 7 cases of hydroaccumulation, 18 cases of hematocele, 11 cases of pneumatosis, 3 cases of scalp swelling, 2 cases of epilepsy, 10 cases of hydrocephalus and 1 case of intracranial infection, and no incision infection occurred. Age and postoperative NIHSS score were related factors affecting the poor prognosis of ultra-early-CP patients (P<0.05). ConclusionUltra-early-CP can promote the recovery of neurological function, reduce the disturbance of consciousness, improve daily living ability and improve cognitive function in patients with craniocerebral trauma, but there is a high risk of postoperative complications. In addition, age and postoperative NIHSS score are related factors affecting the poor prognosis of ultra-early-CP patients.