We studied 16 patients who underwent CP after decompressive craniectomy (DC) for traumatic brain injury. These patients were divided in 2 groups, early and late CP, depending on the interval between DC and CP. Three months was the cutoff time for early CP. Neurocognitive status was assessed by Glasgow Coma Scale, Glasgow Outcome Scale, and Mini-Mental State Examination scores prior to and after CP. Computed tomography (CT) perfusion was done to correlate the improvement in neurologic status and CT perfusion parameters.
We observed that there was a positive influence of CP on neurologic and psychologic function in all of the patients. The neurocognitive improvement after CP was more remarkable in the early CP group. More complications were noted in patients in the late CP group. Brain perfusion after CP showed improvement in all parameters in both of the groups, both on the operated and contralateral side.
Neurocognitive improvement is noted after CP in all of the patients. CP should be offered once the brain edema subsides, at the earliest. Improved cerebral perfusion may be the key factor for the improved functional outcome.