Syndrome of the Trephined: A Systematic Review
Syndrome of the Trephined: A Systematic Review
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DOI：
10.1227/neu.0000000000001366
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发表时间：
2016-10-01
期刊：
影响因子：
4.8
通讯作者：
Gordon, Chad R.
中科院分区：
文献类型：
--
作者：
Ashayeri, Kimberly;Jackson, Eric M.;Gordon, Chad R.
背景技术背景：环钻综合征（SoT）是一种罕见的，重要的并发症，颅骨切除术的特点是神经功能障碍，改善与颅骨成形术。它的各种症状包括运动，认知和语言缺陷。其确切的特征似乎是次优的，有不同的评价方法。因此，这一主题是在很大程度上需要进一步调查。目的：为了准确地描述SoT和探索方法的客观诊断/evaluation.METHODS：电子检索PubMed，MEDLINE，Web of Knowledge，和Psy-cINFO数据库使用的关键词“综合征的环锯”和“下沉皮瓣。“删除了非英文和重复的文章。根据相关性选择标题和摘要综述。全文综述被选为提供SoT patients.RESULTS的个人特征的文章：这篇综述确定SoT最常发生在男性患者（60%）在5.1 +/- 10.8个月后，神经创伤（38%）的颅骨切除术。报告的平均颅骨切除术为88.3 +/- 34.4 cm（2），通常存在“凹陷皮瓣”（93%）。最常见的症状包括运动、认知和语言缺陷（分别为57%、41%、28%），在颅骨成形术后3.8 ± 3.9天内改善。经过2.9 +/- 3.4个月的康复治疗，54.9%的患者实现了日常生活活动的功能独立。然而，SoT的评价是不一致的，只有53%的报告记录客观studies.DISCUSSION：SoT是一个变量的现象与时间延长颅骨成形术。由于目前的弱点，客观性，我们假设，SoT往往是诊断不足，并建议一个多方面的方法一致evaluation.CONCLUSION：SoT是一个严重的并发症，缺乏准确的表征，值得今后的调查。提高理解和认识对早期干预和患者结局具有重要意义。
BACKGROUND: Syndrome of the trephined (SoT) is a rare, important complication of a craniectomy characterized by neurological dysfunction that improves with cranioplasty. Its varied symptoms include motor, cognitive, and language deficits. Its exact characterization appears suboptimal, with differing approaches of evaluation. Accordingly, this topic is in great need of further investigation.OBJECTIVE: To accurately describe SoT and explore methods of an objective diagnosis/evaluation.METHODS: Electronic searches of PubMed, MEDLINE, Web of Knowledge, and Psy-cINFO databases used the key words "syndrome of the trephined" and "sinking skin flap." Non-English-language and duplicate articles were eliminated. Title and abstract reviews were selected for relevance. Full-text reviews were selected for articles providing individual characteristics of SoT patients.RESULTS: This review identified that SoT most often occurs in male patients (60%) at 5.1 +/- 10.8 months after craniectomy for neurotrauma (38%). The average reported craniectomy is 88.3 +/- 34.4 cm(2) and usually exists with a "sunken skin flap" (93%). Symptoms most commonly include motor, cognitive, and language deficits (57%, 41%, 28%, respectively), with improvement after cranioplasty within 3.8 +/- 3.9 days. Functional independence with activities of daily living is achieved by 54.9% of patients after 2.9 +/- 3.4 months of rehabilitation. However, evaluation of SoT is inconsistent, with only 53% of reports documenting objective studies.DISCUSSION: SoT is a variable phenomenon associated with a prolonged time to cranioplasty. Due to current weaknesses in objectivity, we hypothesize that SoT is often underdiagnosed and recommend a multifaceted approach for consistent evaluation.CONCLUSION: SoT is a serious complication that lacks exact characterization and deserves future investigation. Improved understanding and recognition have important implications for early intervention and patient outcomes.