{"id":"788d164f-e765-4974-a67c-074eeab36fe0","slug":"letter-to-the-editor-regarding-can-early-cranioplasty-reduce-the-incidence-of-hydrocephalus-after-decompressive-craniectomy-a-meta-analysis","title":"Letter to the Editor regarding “Can early cranioplasty reduce the incidence of hydrocephalus after decompressive craniectomy? A meta-analysis”","authors":["Taco Goedemans","Dagmar Verbaan","W. Peter Vandertop","Pepijn van den Munckhof"],"abstract":"Background: Nasi and Dobran published a meta-analysis examining the timing of cranioplasty after decompressive craniectomy and its effect on postoperative hydrocephalus. They reported no significant difference in hydrocephalus rates between early and late cranioplasty, but noted a lower incidence in traumatic brain injury patients when early cranioplasty was performed. Summary: The authors of this letter raise concerns regarding the methodology of the meta-analysis by Nasi and Dobran, particularly the lack of adherence to PRISMA guidelines and the significant heterogeneity among the included studies. They argue that the findings may be misleading, as a random effects meta-analysis indicates that early cranioplasty is not associated with a lower incidence of hydrocephalus when accounting for pre-existing conditions. Conclusion: The authors suggest that the conclusions drawn by Nasi and Dobran should be revised, as the evidence does not support the claim that early cranioplasty reduces the incidence of hydrocephalus. A clearer definition of post cranioplasty hydrocephalus is necessary to accurately assess the relationship between cranioplasty timing and hydrocephalus. Keywords: cranioplasty, decompressive craniectomy, hydrocephalus, traumatic brain injury, meta-analysis, methodology, heterogeneity","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/788d164f-e765-4974-a67c-074eeab36fe0/featured/hero-1781563312208.png","publishDate":"2020-07-18T00:00:00.000Z","doi":"10.25259/SNI_311_2020","categories":["General Neurosurgery","Letter to the Editor"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2020/07/10142/SNI-11-198.pdf"}