The Therapeutic Methods Of Cranial Bones Defection Coupled With Subdural Or Under Flap Effusion

Objective To investigate the therapeutic methods of cranial bones defection coupled with subdural or under flap effusion. Methods Collecting76cases who are defection of cranial bones accompanied with subdural or under flap effusion after craniotomy. The patients become chronic effusion after early treatment, who can be divided into three types(resoluted type, stable type and combined type)according to the volume of effusion.44cases of resoluted type do cranioplasty to repair cranial bones directly, except effusion absorbed before surgery.12cases of stable type handle with envelope of effusion cavity resection and cranial bone repair. Another16cases of stable type treated with compression bandage before repair of cranial bones.3cases of combined type placed of ventriculoperitoneal shunt and then surgical repair in appropriate time. Another one case of combined type placed of ventriculoperitoneal shunt and surgical repair at same time. Results Most of resoluted type patients after cranial bone repair cured within2-3months by fellow-up. In addition, only one case the effusion after surgery more than that before repair. We dealt the patient with conservative treatment due to without high cranial pressure and he cured after3months. The cases of stable type were diminish or absorbed, and the remained effusion disappear after a period of time by fellow up. The cases of patients dealt with compression bandage and cranial repair didn’t increase effusion, and cured after2-3months by fellow up. The cases of combined type reached good prognosis after placed of ventriculoperitoneal shunt and surgical repair. Conclusion the surgical treatment of chronic and refractory effusion have good therapeutic effect. Compression bandage combined with skull repair of subdural effusion has a definite therapeutic effect. For the merger hydrocephalus is first deal with hydrocephalus.