{"id":"94f06c31-7f04-44f0-a90e-9e268bcfce73","slug":"can-early-cranioplasty-reduce-the-incidence-of-hydrocephalus-after-decompressive-craniectomy-a-meta-analysis","title":"Can early cranioplasty reduce the incidence of hydrocephalus after decompressive craniectomy? A meta-analysis","authors":["Davide Nasi","Mauro Dobran"],"abstract":"Background: Do alterations of cerebrospinal fluid dynamics secondary to decompressive craniectomy (DC) lead to hydrocephalus, and can this effect be mitigated by early cranioplasty (CP)? In this meta-analysis, we evaluated whether the timing of CP decreased the incidence of postoperative hydrocephalus. Methods: We performed a systematic search of PubMed/MEDLINE, Scopus, and the Cochrane databases using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for English language articles (1990–2020). We included case series, case–control, and cohort studies, and clinical trials assessing the incidence of hydrocephalus in adult patients undergoing early CP (within 3 months) versus late CP (after 3 months) after DC. Results: Eleven studies matched the inclusion criteria. The rate of postoperative hydrocephalus was not significantly different between the early (=96/1063; 9.03%) and late CP (=65/966; 6.72%) group (P = 0.09). Only in the three studies specifically reporting on the rate of hydrocephalus after DC performed to address traumatic brain injury (TBI) alone was there a significantly lower incidence of hydrocephalus with early CP (P = 0.01). Conclusion: Early CP (within 90 days) after DC performed in TBI patients alone was associated with a lower incidence of hydrocephalus. However, this finding was not corroborated in the remaining eight studies involving CP for pathology exclusive of TBI.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/94f06c31-7f04-44f0-a90e-9e268bcfce73/featured/hero-1781563499876.png","publishDate":"2020-05-02T00:00:00.000Z","doi":"10.25259/SNI_120_2020","categories":["Trauma","Review Article"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2020/05/9988/SNI-11-94.pdf"}