Routine postoperative computed tomography scan after craniotomy: systematic review and evidence-based recommendations.

التفاصيل البيبلوغرافية
العنوان:	Routine postoperative computed tomography scan after craniotomy: systematic review and evidence-based recommendations.
المؤلفون:	Blumrich L; Division of Neurosurgery, Hospital das Clínicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), Av. Dr. Eneas de Carvalho Aguiar, 255, Sao Paulo, Brazil., Telles JPM; Division of Neurosurgery, Hospital das Clínicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), Av. Dr. Eneas de Carvalho Aguiar, 255, Sao Paulo, Brazil., da Silva SA; Division of Neurosurgery, Hospital das Clínicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), Av. Dr. Eneas de Carvalho Aguiar, 255, Sao Paulo, Brazil., Iglesio RF; Division of Neurosurgery, Hospital das Clínicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), Av. Dr. Eneas de Carvalho Aguiar, 255, Sao Paulo, Brazil., Teixeira MJ; Division of Neurosurgery, Hospital das Clínicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), Av. Dr. Eneas de Carvalho Aguiar, 255, Sao Paulo, Brazil., Figueiredo EG; Division of Neurosurgery, Hospital das Clínicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), Av. Dr. Eneas de Carvalho Aguiar, 255, Sao Paulo, Brazil. ebgadelha@yahoo.com.
المصدر:	Neurosurgical review [Neurosurg Rev] 2021 Oct; Vol. 44 (5), pp. 2523-2531. Date of Electronic Publication: 2021 Jan 15.
نوع المنشور:	Journal Article; Review; Systematic Review
اللغة:	English
بيانات الدورية:	Publisher: Springer Berlin Heidelberg Country of Publication: Germany NLM ID: 7908181 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1437-2320 (Electronic) Linking ISSN: 03445607 NLM ISO Abbreviation: Neurosurg Rev Subsets: MEDLINE
أسماء مطبوعة:	Publication: Berlin : Springer Berlin Heidelberg Original Publication: Berlin : Walter De Gruyter
مواضيع طبية MeSH:	Craniotomy* , Tomography, X-Ray Computed*, Algorithms ; Humans ; Postoperative Period ; Retrospective Studies
مستخلص:	Over the last few years, the role of early postoperative computed tomography (EPOCT) after cranial surgery has been repeatedly questioned, but there is yet no consensus on the practice. We conducted a systematic review to address the usefulness of EPOCT in association with neurological examination after elective craniotomies compared to the neurological examination alone. Studies were eligible if they provided information about the number of patients scanned, how many were asymptomatic or presented neurological deterioration before the scan and how many of each of those groups had their management changed due to imaging findings. CTs had to be performed in the first 48 h following surgery to be considered early. Eight studies were included. The retrospective studies enrolled a total of 3639 patients, with 3737 imaging examinations. Out of the 3696 CT scans performed in asymptomatic patients, less than 0.8% prompted an intervention, while 100% of patients with neurological deterioration were submitted to emergency surgery. Positive predictive values of altered scans were 0.584 for symptomatic patients and 0.125 for the asymptomatic. The number of altered scans necessary to predict (NNP) one change in management for the asymptomatic patients was 8, while for the clinically evident cases, it was 1.71. The number of scans needed to diagnose one clinically silent alteration is 134.75, and postoperative imaging of neurologically intact patients is 132 times less likely to issue an emergency intervention than an altered neurological examination alone. EPOCT following elective craniotomy in neurologically preserved patients is not supported by current evidence, and CT scanning should be performed only in particular conditions. The authors have developed an algorithm to help the judgment of each patient by the surgeon in a resource-limited context. (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature.)
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فهرسة مساهمة:	Keywords: Craniotomy; Critical care; Neurosurgery; Spiral computed; Tomography
تواريخ الأحداث:	Date Created: 20210116 Date Completed: 20211015 Latest Revision: 20211015
رمز التحديث:	20240628
DOI:	10.1007/s10143-021-01473-w
PMID:	33452594
قاعدة البيانات:	MEDLINE

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DOI:	10.1007/s10143-021-01473-w