Engineering optimization of decompressive craniectomy based on finite element simulations

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Hazay, MátéDepartment of Structural Mechanics, Budapest University of Technology and Economics, Budapest, Hungary (author)

Engineering optimization of decompressive craniectomy based on finite element simulations

Article/chapterEnglish2020

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Wroclaw University of Technology,2020
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LIBRIS-ID:oai:DiVA.org:oru-113232
https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-113232URI
https://doi.org/10.37190/ABB-01689-2020-03DOI

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Language:English
Summary in:English

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Subject category:art swepub-publicationtype

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Funding Agency:Higher Education Excellence Program of the Ministry of Human Capacities
Purpose: The optimal execution of decompressive craniectomy in terms of the size and location of the skull opening is not straightforward. Our main goals are twofold: (1) constructing a design optimization method which can be applied to determine optimal skull opening for individual patient-specific cases and (2) performing a large-scale parametric optimization study to give some guidance in general about the optimal skull opening in case of oedematous brain tissue.Methods: A large number of virtual experiments performed by finite element simulations were applied to determine tendencies of tissue behaviour during surgery. The multiobjective optimization is performed by Goal Programming and Physical Programming methods.Results: Our results show that the postoperative pressure has an approximately linear dependence on the preoperative pressure and the skull opening area, while the damaged brain volume could have a more complex nonlinear dependence on the input data. Based on the averaged results of the parametric optimization study, the optimal skull opening has been determined in the function of the preoperative pressure and the relative importance of the pressure reduction. These results show that the optimal size of the unilateral skull opening is usually between 130-180 cm² and these openings are more beneficial than the currently analysed bifrontal openings.Conclusions: The optimal skull opening is patient-specific and depends on several input data. The presented methodology can be applied to optimize surgery based on these input parameters for different injury types. Based on the results of large-scale parametric study generally applicable approximate results have been provided.

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MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Neurologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Neurology hsv//eng

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Nagy, EmeseDepartment of Structural Mechanics, Budapest University of Technology and Economics, Budapest, Hungary (author)
Toth, PéterDepartment of Neurosurgery, University of Pecs, Pecs, Hungary (author)
Büki, Andras,1966-Department of Neurosurgery, University of Pecs, Pecs, Hungary(Swepub:oru)asbi (author)
Bojtar, Imreepartment of Structural Mechanics, Budapest University of Technology and Economics, Budapest, Hungary (author)
Department of Structural Mechanics, Budapest University of Technology and Economics, Budapest, HungaryDepartment of Neurosurgery, University of Pecs, Pecs, Hungary (creator_code:org_t)

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In:Acta of bioengineering and biomechanics: Wroclaw University of Technology22:4, s. 109-1221509-409X1509-409X

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By the author/editor: Hazay, Máté; Nagy, Emese; Toth, Péter; Büki, Andras, 19 ...; Bojtar, Imre

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Neurology

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