Features of the postoperative period of ultra-early cranioplasty after decompressive cranioectomy in patients with open and closed traumatic brain trauma
Bibliographic record
Abstract
INTRODUCTION . Acquired bone defects of the cranial vault occur after surgical treatment for traumatic brain injury, tumor and vascular pathology of the brain. Cranioplasty performed within one month after decompressive cranioctomy, known as ultra-early cranioplasty (ultra-early CP), can improve neurological function with a lower number of concomitant complications. AIM . To analyze postoperative complications in patients after ultra-early cranioplasty after open and closed traumatic brain injury. MATERIALS AND METHODS . The data of 19 patients with open traumatic brain injury (study group), aged 18 to 68 years (average age 35.3±1.4 years), who were treated for traumatic brain injury and 21 patients with closed traumatic brain injury (control group), in aged 18 to 69 years (average age 35.7±1.3 years), who underwent ultra-early cranioplasty with a titanium mesh within 4–5 weeks after decompressive craniectomy. In all cases, if the dura mater was damaged, it was hermetically repaired with artificial Xeno Dura TMO sealed with Glue Brain glue to prevent cerebrospinal fluid. In patients of the main and control groups, upon admission for ultra-early cranioplasty, on the tenth day of the postoperative period, and one month after cranioplasty, neurological functions were assessed using the National Stroke Institute of Health (NIHSS) Scale, and the level of consciousness was assessed using the Glasgow Coma Scale. RESULTS . The obtained results of assessing the level of consciousness according to the SHG, cognitive functions according to the Montreal Cognitive Function Assessment Scale (MoCA), neurological functions according to the National Stroke Scale of the Institute of Health (NIHSS), general disability and the degree of dependence of the patient on outside help – according to the Rankin scale in patients of the study and control groups before ultra-early cranioplasty, by 10 – the 1st day of the postoperative period and a month after the ultra-early cranioplasty did not differ significantly (p>0.05). However, there was a significant improvement a month after the ultra-early cranioplasty, compared with the preoperative condition (p<0.05). CONCLUSION . Ultra-early cranioplasty should be performed in patients after decompressive cranial trepanation for open and closed craniocerebral trauma as early as possible, subject to mandatory hermetization of the dura mater, since it leads to early recovery of cognitive functions, reduction of disability, restoration of the physiological shape of the cranial vault with the elimination of cosmetic defects and related psychological stress after injuries. Taking into account all the individual characteristics of the patient, ultra-early cranioplasty can be performed in patients with open traumatic brain injury.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".