Keywords:
Epidemiology, Surgery, Complications, MR, CT, Catheter arteriography, Neuroradiology brain
Authors:
P. M. Hernandez Guilabert1, I. Herrera2, M. D. P. Sanchez-Camacho2, M. Amosa2, E. Capilla1, J. M. Garcia Benassi2, M. T. Fernández Taranilla2; 1madrid/ES, 2Toledo/ES
DOI:
10.1594/ecr2013/C-1330
Purpose
The neurosurgical cranial procedures are relatively frequent in the daily practice and a wide range of neurosurgical techniques has been developed to treat patients with intracraneal disorders.
Imaging is important in the routine postoperative follow-up of these patients.
The radiologist must know how to recognize postoperative complications and differentiate them from expected normal findings (Figure 1) because an early and accurate diagnosis is fundamental for proper postoperative care.
Interpretation of postoperative images requires knowledge of the normal cranial anatomy,
the surgical technique employed (burr holes,
craniotomy,
craniectomy or cranioplasty) and also the underlying pathology and the clinical status of the patient.
Clinical,
surgical and radiologic correlation is essential.
In the early postoperative period,
computed tomography (CT) is the main imaging modality used to evaluate potencial complications because it is fast,
accesible in most hospitals,
compatible with monitoring equipment and implanted devices and relatively inexpensive.
CT is useful to evaluate complications such as hemorrhage,
brain edema,
tension neumocephalus,
brain herniation and infection (contrast-enhanced CT).
However,
magnetic resonance imaging (MRI) is more sensitive than CT in detecting intracranial infection and ischemia.
Both CT and MRI are susceptible of artifacts from metallic implants,
which reduce the sensibility of the exploration and make the images more difficult to interpret.
The purpose of this work is to describe the different complications in the neurosurgical procedures performed in our hospital,
and their frequency,
according to the surgical indication and the type of procedure (urgent or programmed).