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Predictors Of Syndrome Of The Trephined Severity Using Patient Related Parameters
Abdulaziz Elemosho MD, Taborah Zaramo BS, Jude Kluemper BS, Kerry-Ann Mitchell MD-PhD
Ohio State University
2024-02-07
Presenter: Abdulaziz Elemosho MD
Affidavit:
I certify that the work presented here is the original work of Zed and other members of the Mitchell Lab. And this work has not been presented at any other meeting
Director Name: Gregory Pearson MD
Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Syndrome of the trephined is an important complication following decompressive craniectomy, and it could manifest with motor, cognitive or behavioral deficits. The critical size craniectomy defect for the development of SoT remains unknown. It is important to delineate, if any, the relationship between multiple patient's parameters and the eventual development and resolution of SoT.
METHODS
Data was collected on patients who had an assessment with the Activity Measure for Post Acute Care AM-PAC system, before and after cranioplasty between 2014 and 2022. SoT was diagnosed based on a difference of atleast a score of 2 in pre-craniectomy and post-craniectomy AM-PAC score in any of the domains. Patients who had SoT were further subclassified according to severity.
RESULTS
Of the 160 patients who underwent decompressive craniectomy, 43 patients were assessed using the AM-PAC system. 28 patients had SoT based on our inclusion criteria. 14 patients had severe SoT. Patients in the SoT group had a significantly higher mean cranial defect size 155.86±76.7 (p=0.0087). Similarly, patients in the severe SoT group had a significantly higher mean cranial defect size (197.33±65.76) (p=0.013). There was no difference in age, smoking status, comorbidities, types of primary brain injury between SoT group and the non-SoT group.
CONCLUSION
Patients undergoing craniectomy should receive a neurologic assessment at multiple timepoints while on admission. This will increase the index of detection of SoT. SoT should be anticipated in patients who are undergoing large sized craniectomy.
