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PubMed1992

[Decompressive craniotomy and its effect on recovery and rehabilitation of the patient].

The rehabilitation of patients who have to be operated on because of severe craniocerebral trauma and in whom the roof of the cranium must be removed because of severe post-traumatic cerebral oedema, is extremely difficult. The slow rehabilitation and recovery of these patients, who also show psychological changes in most cases, must be attributed to the pathological intracranial conditions which have arisen in consequence of large defects in cranial bones. A causal correlation between severe pathological intracranial conditions, which have arisen not only from trauma but also from bone flap decompressions, and protracted postoperative recovery and difficult rehabilitation has only recently been established. Our experience has shown that rapid rehabilitation of the injured person can only be expected after skullcap reconstruction and normalization of intracranial conditions.

Adult↗
PubMed2004

[Study on the syndrome-effect relationship of treatment for post-craniotomy fever treated by combination of naoreqing oral liquid and western medicine].

OBJECTIVE: To observe the antifebrile effect of Naoreqing oral liquid (NRQ) in treating post-craniotomic fever, its relationship with the Syndrome type of fever, and the effect of treatment in improving main symptoms. METHODS: Patients were randomly divided, according to the ward they accommodated, into three groups, the 86 patients in the TCM group treated with NRQ, the 276 in the TCM-WM group with NRQ plus western medicine (WM) and the 89 in the WM group with WM alone. The antifebrile effect of treatment and the degree of body temperature subsidence in groups were compared, relationship between TCM Syndrome type and antifebrile effect was analyzed and the changes of scores of main symptoms before and after treatment were observed. RESULTS: The degree of body temperature subsidence and the total antifebrile effective rate in the TCM and the TCM-WM group were similar and better than those in the WM group (P < 0.01). In the TCM-WM group, the antifebrile effects in patients with various Syndrome types, in high to low order, were Dampness-Heat type > Inner-Heat type > Phlegm-Heat type, and the treatment showed definite antifebrile effect in improving main symptoms of patients of various types. CONCLUSION: Combination of NRQ and WM has definite antifebrile effect in treating post-craniotomic fever, in a Syndrome-effect dependent manner. At the same time, it also could markedly relieve the various symptoms in patients.

Analgesics, Non-Narcotic↗
PubMed1992

[Craniotomy for lesions in the cerebral convexity; how to precisely localize the lesions with conventional CT slices].

A simple direct precise localization with a CT scan for convexity lesions is presented. The shape of the normal calvarium was analyzed and a characteristic pattern was obtained, that is, one spherical surface in the frontal area and 6 flat planes in the temporal, parietal and occipital areas. The temporal plane is perpendicular to the orbito-meatal line (OML), while the parietal plane declined 29 degrees in the A-P view, and the occipital plane declined 60 degrees in the lateral view. A summit of these three planes forming the parietal tubercle, and the crest following the tubercle between the parietal and occipital planes were detected either by CT scan, or by palpating the skull. Conventional methods of preoperative localization include measurement and calculation from the base line such as OML, or obtaining a CT scan with a marker on the scalp. The former might have an error that will be amplified in the parietal region that would not be negligible. The latter is a rather troublesome method demanding that the CT scan be taken after shaving the hair. Landmarks utilized for the localization should be identified both on the CT scan and on the scalp or skull. These involved OML, coronal suture, parietal tubercle, inion, pineal body, midline and so on. Of these, the coronal suture runs almost perpendicular to the OML and would be the best landmark for the localization in the parietal area.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain↗
PubMed2004

[Craniotomy and the temporal branch of the facial nerve].

The surgical anatomy of the temporal branch of the facial nerve was studied in the anatomical laboratory. The temporal branch divides into an anterior, middle (frontal), and a posterior ramus after it pierces the parotid fascia. The anterior ramus innervates orbicularis oculi and corrugator supercilii muscles; the middle branch is for the ipsilateral frontalis muscle. The posterior branch innervates the anterior and superior auricular and tragus muscles. Below the zygomatic arch, the temporal branch of the facial nerve is located in the subcutaneous tissue. Above the arch, it continues in the subgaleal space with the superficial temporal fascia deeply. The terminal twigs of the temporal branch penetrate the galea to reach their target muscles that are all located superficial to the galea. There is a significant variability in the course of the temporal branch of the facial nerve. Occasionally, the terminal twigs of the middle ramus may penetrate superficial layer of superficial temporal fascia and run in the intrafascial fat pad before entering the frontalis muscle. There are four available operative techniques in this anatomical location. The subgaleal dissection of a temporofrontal scalp flap is associated with a high incidence of postoperative palsy of the temporal branch of the facial nerve and cosmetically bothersome results. Reflecting the scalp and temporalis muscle together as a single layer is the safest procedure. Unfortunately, this technique can not be used for the transzygomatic approaches and the bulky temporalis muscle may compromise basal exposure in the pterional route. Third technique was described and propagated by Yasargil. He proposed a subgaleal dissection up to the anterior one-fourth of the temporalis muscle where the dissection has to be deepened between the two layers of the superficial temporal fascia (in the interfascial fat pad). This approach may also infrequently injure the temporal branch in case of anatomical variation. The last available operative technique raises the superficial temporal fascia together with the scalp.

Craniotomy↗