Effect of Cranioplasty on the Cerebral Hemodynamics and Stroke Volume

Huh, Han Yong; Yoo, Do Sung; Huh, Phil Woo; Cho, Kyoung Suok; Kim, Dal Soo; Kim, Moon Chan

Abstract

OBJECTIVE
The objective of this study is to examine the effects of cranioplasty on the cerebral hemodynamics and cardiac function. METHODS: Twenty seven patients who had undergone cranioplasty were included in this study. Arterial blood flow velocities were assessed by transcranial doppler ultrasonography and the cerebral blood flow(CBF) measurements by perfusion computed tomography. Cardiac functions were evaluated using the echocar-diogram. RESULTS: The blood flow velocity on the cranioplasty side was decreased from 50.5+/-15.4cm/sec to 38.1+/-13.9cm/sec at the middle cerebral artery(MCA) and from 33.1+/-8.3cm/sec to 26.4+/-6.6cm/sec at the internal carotid artery(ICA)(p<0.05). On the opposite side, it was decreased from 61.9+/-15.7cm/sec to 48.7+/-16.9cm/ sec at the MCA and from 31.8+/-7.3cm/sec to 24.5+/-7.1cm/sec at the ICA(p<0.05). The evaluation of cardiac functions revealed that the stroke volume was increased from 64.7+/-18.3ml/beat to 73.3+/-20.4ml/beat(p< 0.05) ; the heart rate was decreased from 91.4+/-14.7beat/min to 82.2+/-15.1beat/min(p<0.05). CBF was increased from 39.1+/-7.2ml/100g/min to 44.7+/-8.9ml/100g/min on the cranioplasty side(p<0.05). CONCLUSION: Cranioplasty can remove the atmospheric pressure on the brain and may decrease the blood flow velocity and increase the CBF as well as improve the cardiac function. The authors insist that a skull defect should be corrected as quickly as possible after neurological stabilization of patients.