Consensus-based recommendations for diagnosis and surgical management of cranioplasty and post-traumatic hydrocephalus from a European panel
(2024) In Brain and Spine 4.- Abstract
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.”... (More)
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.
(Less)
- author
- Iaccarino, Corrado
; Chibbaro, Salvatore
; Sauvigny, Thomas
; Timofeev, Ivan
; Zaed, Ismail
; Franchetti, Silvio
; Mee, Harry
; Belli, Antonio
; Buki, Andras
; De Bonis, Pasquale
; Demetriades, Andreas K.
; Depreitere, Bart
; Fountas, Kostantinos
; Ganau, Mario
; Germanò, Antonino
; Hutchinson, Peter
; Kolias, Angelos
; Lindner, Dirk
; Lippa, Laura
; Marklund, Niklas
LU
; McMahon, Catherine
; Mielke, Dorothee
; Nasi, Davide
; Peul, Wilco
; Poca, Maria Antonia
; Pompucci, Angelo
; Posti, Jussi P.
; Serban, Nicoleta Larisa
; Splavski, Bruno
; Florian, Ioan Stefan
; Tasiou, Anastasia
; Zona, Gianluigi
and Servadei, Franco
(Less) - organization
- publishing date
- 2024
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Cranioplasty, Diagnosis, Post-traumatic hydrocephalus, Surgical strategy
- in
- Brain and Spine
- volume
- 4
- article number
- 102761
- publisher
- Elsevier
- external identifiers
-
- pmid:38510640
- scopus:85185576973
- ISSN
- 2772-5294
- DOI
- 10.1016/j.bas.2024.102761
- language
- English
- LU publication?
- yes
- id
- 27ece720-19c6-492e-bd18-13c777e81096
- date added to LUP
- 2024-03-22 13:23:15
- date last changed
- 2024-04-19 14:30:07
@article{27ece720-19c6-492e-bd18-13c777e81096,
abstract = {{<p>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.</p>}},
author = {{Iaccarino, Corrado and Chibbaro, Salvatore and Sauvigny, Thomas and Timofeev, Ivan and Zaed, Ismail and Franchetti, Silvio and Mee, Harry and Belli, Antonio and Buki, Andras and De Bonis, Pasquale and Demetriades, Andreas K. and Depreitere, Bart and Fountas, Kostantinos and Ganau, Mario and Germanò, Antonino and Hutchinson, Peter and Kolias, Angelos and Lindner, Dirk and Lippa, Laura and Marklund, Niklas and McMahon, Catherine and Mielke, Dorothee and Nasi, Davide and Peul, Wilco and Poca, Maria Antonia and Pompucci, Angelo and Posti, Jussi P. and Serban, Nicoleta Larisa and Splavski, Bruno and Florian, Ioan Stefan and Tasiou, Anastasia and Zona, Gianluigi and Servadei, Franco}},
issn = {{2772-5294}},
keywords = {{Cranioplasty; Diagnosis; Post-traumatic hydrocephalus; Surgical strategy}},
language = {{eng}},
publisher = {{Elsevier}},
series = {{Brain and Spine}},
title = {{Consensus-based recommendations for diagnosis and surgical management of cranioplasty and post-traumatic hydrocephalus from a European panel}},
url = {{http://dx.doi.org/10.1016/j.bas.2024.102761}},
doi = {{10.1016/j.bas.2024.102761}},
volume = {{4}},
year = {{2024}},
}