The effect of early cranioplasty on neurologic and cognitive function in patients with traumatic brain injury after decompression of bone flap

Abstract

Objective To investigate the effects of early cranioplasty on neurologic and cognitive function in patients with traumatic brain injury (TBI) after decompression of bone flap. Methods One hundred and six patients with TBI who underwent cranioplasty after decompression of bone flap were selected from January 2016 to December 2019, and were divided into early cranioplasty group (48 cases, 1-3 months after decompression) and conventional cranioplasty group (58 cases, 3-6 months after decompression). Before and 6 months after operation, Glasgow Outcome Scale (GOS), modified Rankin Scale (mRS), National Institutes of Health Stroke Scale (NIHSS) and Mini⁃Mental State Examination (MMSE) were utilized, and recorded syndrome of the trephine incidence of 6 months after craniotomy decompression. Results At 6 months after craniotomy decompression, GOS (P=0.000) and MMSE (P= 0.000) scores of both groups were significantly higher than those before craniotomy decompression, while mRS (P =0.000) and NIHSS (P =0.000) scores were significantly lower than those before craniotomy decompression. GOS (P = 0.041) and MMSE (P = 0.040) scores in the early cranioplasty group were significantly higher than those in the conventional cranioplasty group, while mRS (P=0.021) and NIHSS (P =0.043) scores were significantly lower than those in the conventional cranioplasty group，and the incidence of syndrome of the trephine was also lower than that in the conventional cranioplasty group [18.75% (9/48) vs. 39.66% (23/58); χ2 =5.446, P =0.020]. Conclusions Early cranioplasty for TBI patients after cranioplasty decompression with bone⁃removing flap can effectively improve activities of daily living, nerve function and cognitive function, reduce the incidence of syndrome of the trephine, and improve prognosis and long⁃term quality of life.

DOI：10.3969/j.issn.1672⁃6731.2020.07.011