Early one-stage ventriculo-peritoneal shunt and cranioplasty for patients with postoperative skull deficit and hydrocephalus

Objective To investigate the therapic efficiency of early one-stage ventriculo-peritoneal shunt and cranioplasty on patients with skull deficit,hydrocephalus and hernia in the cerebral tissue of deficited skull after large flap decompression.Methods Thirty-eight patients with skull deficit,hydrocephalus and hernia in the cerebral tissue of deficited skull after large flap decompression,admitted to our hospital from June 2009 to December 2010,were chosen in our study;early (within two months of onset) one-stage ventriculo-peritoneal shunt and cranioplasty were performed on these patients; follow up was performed for 6-24 months.Results Postoperative CT scan 10 days after the surgery showed that hydrocephlus disappeared in 31 patients and significantly alleviated in 7; the midline located on the middle of the brain,and the titanium structure in the skull deficit was good.The follow-up of 6-24 months (mean 13 months) indicated that hydrocephlus disappeared in 30 patients,significantly alleviated in 6,and recurred in 2 patients under CT scan; recurred hydrocephalus disappeared after a new re-operation of ventriculo-peritoneal shunt.Conslusion The early one-stage ventriculo-peritoneal shunt and cranioplasty could achieve favorable outcome for patients with skull deficit,hydrocephalus and hernia in the cerebral tissue of deficited skull after large flap decompression. Key words: Large flap decompression; Hydrocephalus; Skull deficit; Ventriculo-peritoneal shunt; Cranioplasty