Sistema de Salut de Catalunya
Institut Català de la Salut
[Iaccarino C] School of Neurosurgery, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy. Neurosurgery Unit, University Hospital of Modena, Modena, Italy. Neurosurgery Unit, AUSL RE IRCCS, Reggio Emilia, Italy. [Chibbaro S] Neurosurgery Department, University of Siena, AOUS Le Scotte, Siena, Italy. [Sauvigny T] Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. [Timofeev I] Department of Neurosurgery, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK. [Zaed I] Department of Neurosurgery, Neurocenter of the Southern Switzerland, Regional Hospital of Lugano, Lugano, Switzerland. [Franchetti S] Neurosurgery Unit, AUSL RE IRCCS, Reggio Emilia, Italy. [Poca MA] Centre de Recerca Matemàtica (CRM), Bellaterra, Spain. Servei de Neurocirurgia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Departament de Cirurgia, Universitat Autònoma de Barcelona, Bellaterra, Spain
Vall d'Hebron Barcelona Hospital Campus
2024-03-22T09:16:07Z
2024-03-22T09:16:07Z
2024-01-26
Cranioplasty; Post-traumatic hydrocephalus; Surgical strategy
Craneoplastia; Hidrocefalia postraumática; Estrategia quirúrgica
Cranioplàstia; Hidrocefàlia posttraumàtica; Estratègia quirúrgica
Introduction Planning cranioplasty (CPL) in patients with suspected or proven post-traumatic hydrocephalus (PTH) poses a significant management challenge due to a lack of clear guidance. Research question This project aims to create a European document to improve adherence and adapt to local protocols based on available resources and national health systems. Methods After a thorough non-systematic review, a steering committee (SC) formed a European expert panel (EP) for a two-round questionnaire using the Delphi method. The questionnaire employed a 9-point Likert scale to assess the appropriateness of statements inherent to two sections: "Diagnostic criteria for PTH" and "Surgical strategies for PTH and cranial reconstruction." Results The panel reached a consensus on 29 statements. In the "Diagnostic criteria for PTH" section, five statements were deemed "appropriate" (consensus 74.2−90.3 %), two were labeled "inappropriate," and seven were marked as "uncertain." In the "Surgical strategies for PTH and cranial reconstruction" section, four statements were considered "appropriate" (consensus 74.2−90.4 %), six were "inappropriate," and five were "uncertain." Discussion and conclusion Planning a cranioplasty alongside hydrocephalus remains a significant challenge in neurosurgery. Our consensus conference suggests that, in patients with cranial decompression and suspected hydrocephalus, the most suitable diagnostic approach involves a combination of evolving clinical conditions and neuroradiological imaging. The recommended management sequence prioritizes cranial reconstruction, with the option of a ventriculoperitoneal shunt when needed, preferably with a programmable valve. We strongly recommend to adopt local protocols based on expert consensus, such as this, to guide patient care.
This project was conducted with the non-conditioning assistance of Integra LifeSciences.
Article
Published version
English
Qüestionaris; Hidrocefàlia; Crani - Cirurgia; Crani - Malformacions; DISEASES::Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Hydrocephalus; INFORMATION SCIENCE::Information Science::Systems Analysis::Delphi Technique; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Surgical Procedures, Operative::Decompression, Surgical::Decompressive Craniectomy; PSYCHIATRY AND PSYCHOLOGY::Behavior and Behavior Mechanisms::Psychology, Social::Group Processes::Consensus; ENFERMEDADES::enfermedades del sistema nervioso::enfermedades del sistema nervioso central::enfermedades cerebrales::hidrocefalia; CIENCIA DE LA INFORMACIÓN::Ciencias de la información::análisis de sistemas::técnica Delfos; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::intervenciones quirúrgicas::descompresión quirúrgica::craniectomía descompresiva; PSIQUIATRÍA Y PSICOLOGÍA::conducta y mecanismos de la conducta::psicología social::procesos de grupo::consenso
Elsevier
Brain and Spine;4
https://doi.org/10.1016/j.bas.2024.102761
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
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