A Clinical Research And Analysis Of The Pathogenic Factors Of Early Epilepsy After Craniocerebral Trauma And The Influence Of VNS Cranioplasty On The Occurrence Rate Of Secondary Epilepsy

Objective: Analyze the dangerous factors of early epilepsy after craniocerebral trauma;Explore the curative effect of VNS on medically intractable epilepsy after craniocerebral trauma;Study the influence of cranioplasty for patients undergo decompressive craniotomy after craniocerebral trauma with titanium mesh on the occurrence of epilepsy.Methods: Retrospectively analyze 88 patients with craniocerebral injury received and treated by the Neurosurgery Department of Pudong Hospital affiliated to Fudan University between January 2014 and January 2016.Conducte a research of related factors to the patients who were diagnosed with epilepsy(early epilepsy)within a week after craniocerebral injury;Use statistical approaches including single factor analysis and Logistic regression analysis to carry out statistical analysis of related factors including age,gender,open craniocerebral injury or not,the degree of disturbance of consciousness,fracture of skull or not,and cerebral injury characteristics etc.Retrospectively analyze 35 patients who diagnosed with secondary medically intractable epilepsy and received VNS stimulator implantation at the Department of Functional Neurology of Renji Hospital between January 2009 to September 2013;Arrange follow-up visits to check the occurrence of epilepsy after VNS stimulator implantation.Emphatically analyze the curative effect of VNS on secondary medically intractable epilepsy after craniocerebral injury.Retrospectively analyze 61 patients who received craniotomy and cranioplasty at the Neurosurgery Department of Pudong Hospital affiliated to Fudan University between March 2014 and March 2016.Researche the occurrence rates of epilepsy before and after cranioplasty respectively;Compare the occurrence rate of epilepsy between the 61 patients and other 41 patients with craniocerebral injury who received decompressive craniectomy only and did not undergo cranioplasty at the same department and the same hospital during the corresponding period.Conclusion: The occurrence rate of early epilepsy after fracture of skull is statistical importance.The VNS stimulator implantation has a clear effect on patients with medically intractable epilepsy after craniocerebral trauma.One week later after cranioplasty,the incidence of epilepsy is higher than that before operation,and the difference is statistically significant(P ? 0.05).But,there is no significant difference in the incidence of epilepsy within a week after cranioplasty(P?0.05).The incidence of epilepsy after cranioplasty is higher in patients with traumatic brain injury than in those who do not have cranioplasty at the same time,and the difference is statistically significant(P?0.05).