Analyses of Factors Influencing Scalp Atrophy after Pterional Craniotomy in the Elderly

Abstract

Objective: Pterional craniotomy can cause cosmetic defect due to temporalis muscle atrophy and bony removal in the temporal fossa. However, there has been no report related to the whole scalp atrophy in the elderly. Therefore, we inves tigated the influencing factors on the scalp atrophy after pterional craniotomy in the elderly.Methods: Between January 2013 and December 2015, 56 patients, aged >65 years, with subarachnoid hemorrhage underwent pterional craniotomy. Patients were divided into two groups according to the presence or absence of the scalp atrophy. The clinical and radiological factors of the two groups were retrospectively analyzed.Results: The injury of superficial temporal artery showed statistically significant difference between two groups (p<0.001). All patients with STA sacrifice showed scalp atrophy. In terms of the respective changes of scalp layers between no atrophy and atrophy groups, skin to galea aponeurosis (no atrophy group: mean 10.2 mm versus atrophy group: mean 9.2 mm; p<0.001), fat pad thickness (no atrophy group: mean 2.5 mm versus atrophy group: mean 2.3mm; p=0.009), and muscle thickness (no atrophy group: mean 4.3mm versus atrophy group: mean 4mm; p=0.013) showed statistically significant differences.Conclusion: After pterional craniotomy, the scalp atrophy in the elderly may be related to changes of skin to galea aponeurosis and fat pad as well as temporalis muscle atrophy. And, injury of superficial temporal artery should be considered as an influencing factor on the scalp atrophy after pterional craniotomy.