ĐÁNH GIÁ KẾT QUẢ PHẪU THUẬT ĐIỀU TRỊ DÃN NÃO THẤT – KHUYẾT SỌ

Abstract

Background: Patients with hydrocephalus and cranial defects require cranioplasty and ventriculoperitoneal shunting, but whether these surgeries should be performed simultaneously or in separate stages remains uncertain. Methods: From August 2020 to October 2022, the Neurosurgery Department I at Viet Duc Friendship Hospital performed surgery on 27 patients with hydrocephalus and cranial defects after traumatic brain injury. Collected data included age, gender, Glasgow Coma Scale scores pre-surgery, 24-hour post-drainage, and 1-month post cranioplasty; as well as post-operative complications. Results: A total of 27 patients were included: 14 underwent both surgeries simultaneously, and 13 underwent the surgeries in two stages. The average age was 39.6 ± 16.6 years, with a male-to-female ratio of 23:4. The average distance from the upper edge of the craniectomy to the midline was 19.35 ± 8.76 mm. Pre-surgery Glasgow Coma Scale score was 9.96 ± 1.53, and post-24-hour drainage score was 10.41 ± 1.74. The average thickness of the epidural hematoma in the simultaneous surgery group was 9.71 mm, while in the two-stage group, it was 4.23 mm. The brain contusion rate was 6/14 in the simultaneous group and 1/13 in the two-stage group. Four patients in the simultaneous surgery group required reoperation. The overall complication rates in the simultaneous and two-stage surgery groups were 9/14 and 2/13, respectively.