Objective: Decompressive craniectomy as a treatment is often used in the rescue treatment of critically ill patients in neurosurgery; however, there are many complications after this operation. Subdural effusion is a common complication after decompressive craniectomy. Once it occurs, it can cause further problems for the patient. Therefore, the purpose of this study was to explore the safety and effectiveness of pressure dressings for subdural effusion after decompressive craniectomy. Methods: Patients who underwent decompressive craniectomy in our hospital from January 2016 to January 2021 were included in this study, and all patients were followed up for 6 months or more. After the operation, the patients were divided into two groups according to whether they received a pressure dressing or a traditional dressing. Subdural effusion, cerebrospinal fluid leakage, hydrocephalus and other complications were compared between the two groups, and the differences in hospital duration, cost and prognosis between the two groups were analyzed. Results: A total of 123 patients were included in this study. Among them, 62 patients chose pressure dressings, and 61 patients chose traditional dressings. The incidence of subdural effusion in the pressure dressing group was significantly lower than that in the traditional dressing group (P< 0.05). There was no difference between the two groups in cerebrospinal fluid leakage and hydrocephalus (P > 0.05). In addition, the length of hospital stay and the total cost in the pressure dressing group were significantly lower (P< 0.05). Conclusion: Pressure dressing can effectively reduce the occurrence of subdural effusion after decompressive craniectomy, and it does not increase the occurrence of other cerebrospinal fluid-related complications.

Background: Traumatic brain injury (TBI) has been a worldwide problem for neurosurgeons. Patients with severe TBI may undergo craniotomy. These patients often require sedation after craniotomy. Dexmedetomidine (DEX) has been used in patients receiving anesthesia and in intensive care units. Not much is known about the postoperative effect of DEX in patients with severe TBIs undergoing craniotomy. The purpose of this study was to explore the effects of postoperative DEX administration on severe TBI patients who underwent craniotomy. Methods: Patients who underwent craniectomy for severe TBI at our hospital between January 2019 and February 2022 were included in this study. The patients were admitted to the intensive care unit (ICU) after surgery to receive sedative medication. The patients were then divided into DEX and control groups. We analyzed the sedation, hemodynamics, and other conditions of the patients (hypoxemia, duration of ventilation during endotracheal intubation, whether tracheotomy was performed, and the duration in the ICU) during their ICU stay. Other conditions, such as delirium after the patients were transferred to the general ward, were also analyzed. Results: A total of 122 patients were included in this study. Among them, 53 patients received DEX, and the remaining 69 did not. The incidence of delirium in the general ward in the DEX group was significantly lower than that in the control group (P < 0.05). The incidence of bradycardia in the control group was significantly lower than that in the DEX group (P < 0.05). Other data from the DEX group and the control group (hypotension, hypoxemia, etc.) were not significantly different (P > 0.05). Conclusion: The use of DEX in the ICU can effectively reduce the incidence of delirium in patients who return to the general ward after craniotomy. DEX had no adverse effect on the prognosis of patients other than causing bradycardia.

Both estimated glucose disposal rate (eGDR) and a body shape index (ABSI) are closely associated with the incidence of stroke. However, they are rarely used in combination. The aim of this study is to investigate the potential association between the combined use of eGDR and ABSI and the development of stroke. This study utilized data from the China Health and Retirement Longitudinal Study (CHARLS), including a total of 8,719 participants. After a follow-up period of up to nine years, data were collected on participants' sociodemographic information, marital status, health-related behaviors, the presence of underlying conditions, basic anthropometric measurements, and laboratory test results. Cox regression analysis was performed to examine the association between different subgroups and stroke incidence, and receiver operating characteristic (ROC) curves were used to evaluate predictive value. Meanwhile, we conducted subgroup analyses to explore the predictive performance across different populations. Among these participants, a total of 642 experienced a stroke during the follow-up period. Adjusted Cox regression models indicated that eGDR and ABSI were predictors of stroke. The hazard ratio (HR) for eGDR was 0.577 (95% CI: 0.454-0.734), and the HR for ABSI was 1.424 (95% CI: 1.120-1.812). Restricted cubic spline regression revealed the associations of ABSI and eGDR with stroke. There was no statistically significant difference in diagnostic performance for stroke incidence between eGDR alone and the combination of ABSI and eGDR (P = 0.080); however, a statistically significant difference was observed between ABSI alone and the combination (P < 0.001). Subgroup analyses further validated the robustness of the association between the combination of eGDR and ABSI and the development of stroke. The combined prediction of eGDR and ABSI has a certain clinical value, as it can help identify individuals at risk of stroke in the general population, thereby enabling monitoring and intervention based on this combined index to reduce the burden of stroke.