To investigate the effect of cranioplasty on prognosis of patients accepted intracranial aneurysm clipping combined with simultaneous decompressive craniectomy.

One hundred and forty-four patients accepted intracranial aneurysm clipping combined with simultaneous decompressive craniectomy (first-stage operation) in our hospital from January 2013 to June 2017 were chosen; there were 56 patients without cranioplasty in the control group and 88 patients with cranioplasty (second-stage operation) in the observation group. The degrees of coma before first-stage operation were assessed by Glasgow coma scale (GCS). The general state three months after first-stage operation was assessed by GCS and activity of daily living(ADL) scale. The prognoses of these patients 9 and 15 months after first-stage operation were assessed by Glasgow outcome scale (GOS) and ADL scale. The clinical data, prognoses and incidence of hydrocephalus of patients from the two groups were compared. Related factors associated with hydrocephalus were analyzed by multivariate Logistic regression analysis.

GCS, GOS and ADL scale scores in the observation group 9 and 15 months after first-stage operation were all significantly higher than those in the control group (P<0.05); incidence of hydrocephalus in the observation group after first-stage operation (31.82%) was significantly lower than that in the control group (62.5%, P<0.05). Logistic regression model revealed that cranioplasty, Hunt-Hess grading and Fisher grading were independent related factors for incidence of hydrocephalus (P<0.05); cranioplasty was the protective factor of hydrocephalus (OR=0.126), and Hunt-Hess grading and Fisher grading were the risk factors of hydrocephalus (OR=5.311 and 5.073).

Cranioplasty can reduce the incidence of hydrocephalus and improve the prognosis of patients accepted intracranial aneurysm clipping combined with simultaneous decompressive craniectomy.

Cranioplasty; Intracranial aneurysm; Decompressive craniectomy; Hydrocephalus; Prognosis