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Effect of cranioplasty on cerebrospinal fluid hydrodynamics in patients with the syndrome of the trephined

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Summary

Forty patients with cranial bone defects after craniectomy underwent extensive cerebrospinal fluid (CSF) hydrodynamic investigations by means of a CSF infusion test before and after cranioplasty. The results of these investigations were related to the clinical signs of the patients before and after cranioplasty and to the size and location of the skull bone defect. Twenty-two patients were considered to have “the syndrome of the trephined” (ST). The remaining patients were either free of symptoms or had symptoms not related to ST.

CSF hydrodynamic variables that were changed before and normalized after cranioplasty include the following: Resting pressure, sagittal sinus pressure, buffer volume, elastance at resting pressure and pulse variations at resting pressure. The changes were statistically significant mainly in ST patients who were also relieved of their symptoms after cranioplasty.

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This investigation was approved by the Ethical committee, Umeå University Hospital and supported by grants from the Swedish Medical Research Council (Project No. 04X-04125) and from the Amanda Vilhelmina and Per Algot Mångbergs Foundation for Medical Research, University of Umeå.

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Fodstad, H., Love, J.A., Ekstedt, J. et al. Effect of cranioplasty on cerebrospinal fluid hydrodynamics in patients with the syndrome of the trephined. Acta neurochir 70, 21–30 (1984). https://doi.org/10.1007/BF01406039

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