Haseki Tıp Bülteni (Nov 2023)

Factors Associated with Non-Hemorrhagic Extra-Axial Fluid Collection after Cranioplasty

  • Aykut Akpinar,
  • Tuncer Tascioglu

DOI
https://doi.org/10.4274/haseki.galenos.2023.9022
Journal volume & issue
Vol. 61, no. 5
pp. 373 – 378

Abstract

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Aim: Even though, cranioplasty (CP) is an easy surgery to perform, reoperation rate is high because of complications like infection, new-onset seizure, bone flap resorption, hydrocephalus, intracranial hemorrhage, and extra-axial fluid collection (EAFC). Epidural fluid collection is not well described in the literature. In this context, we aimed to evaluate non-hemorrhagic EAFC collections seen after CP procedure. Methods: From May 2016 to December 2021, Patients with or without EAFC who have undergone CP were retrospectively evaluated with the parameters of age, gender, first surgical diagnosis, the material used in CP, sinking skin flap presence, midline shift (MS), comorbidity factors, pre-operative duration, length of hospital stay in the first surgery, pre-and post-operative Glasgow outcome scores, bleeding in the surgical site, EAFC, infection, hydrocephalus, CP area, new-onset seizure after CP, reoperation risk and reoperation time. Results: A total of 106 patients, 70 male, and 36 female, with a mean age of 39.13±17.86 were included in the study. The number of patients with EAFC is 49 and the number of patients without EAFC is 57. The mean hospital stay day of EAFC (+) group (38.28±36.54) is longer and statistically significant compared to the EAFC (-) group (22.19±24.87) (p=0.009). Time interval between surgeries for EAFC (+) group was 215.51±284.28 days and EAFC (-) group was 226.26±509.36 days. Re-operations were performed in 16 of 49 patients who developed EAFC (32.6%) (p=0.022). Infections 68% (n=11), intracerebral hemorrhage 6.2% (n=1), seizure (6.2%), MS (6.2%), subgaleal effusion (6.2%), hydrocephalus (6.2%). Re-operation time EAFC (+) is 5.2±5.41 months and EAFC (-) 20.55±21.3 months (p=0.041). Conclusion: Particularly in frail patients with a longer hospital stay, after CP, EAFC cases should be closely follow up due to the risk of re-surgery as a result of infection.

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