- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03791996
Cranioplasty Cognitive Outcome Study
Impact of Cranioplasty on Cognitive Outcome: A Multi-Center Prospective Randomized Study
This will be a multicenter prospective randomized study of adult patients with an acquired skull defect as a result of craniectomy and considered suitable for cranioplasty, i.e. reconstruction of the skull defect, at all seven Hong Kong Hospital Authority neurosurgical units. Patients that underwent their primary craniectomy operation at any of the Hospital Authority neurosurgery centers from the 1st March 2019 and considered suitable for cranioplasty will be included in this study. Those who underwent their primary craniectomy before 1st March 2019 or at an institution other than the aforementioned neurosurgical units will be excluded. Data from clinical records, operation notes, medication-dispensing records, laboratory records and radiological reports will be collected.
30 adult patients with craniectomy will be recruited and randomized into two groups: "early" cranioplasty, i.e. performed within 3 months of craniectomy, and "late", i.e. cranioplasty performed more than 3 months after the operation. The aim of the study is to determine whether early cranioplasty can improve on patient's cognitive performance compared to those who undergo the procedure after 3 months.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Calvin Mak, MBBS FRCS
- Phone Number: 35066026
- Email: mhk349@ha.org.hk
Study Contact Backup
- Name: Marina Lee
- Phone Number: 35066026
- Email: leeymm@ha.org.hk
Study Locations
-
-
Hong Kong
-
Hong Kong, Hong Kong, China
- Recruiting
- Kwong Wah Hospital
-
Principal Investigator:
- Peter YM Woo, FRCS (SN)
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age greater than or equal to 18 years-old,
- Craniectomy was performed due to head injury, infarct or spontaneous intracerebral hemorrhage, and benign tumors.
- Craniectomy skull defect size of >10cm at its longest diameter
- Craniectomy performed at any of the Hospital Authority's Neurosurgical Centers after 1st March 2019
Exclusion Criteria:
- Age older than 80 years-old,
- Patients cannot communicate by obeying simple command,
- Patients who are unfit for cranioplasty as decided by the treating neurosurgeon
- Posterior fossa craniectomy
- Craniectomy performed before 1st March 2019
- Craniectomy performed at an institution outside the Hospital Authority
- Any pre-existing illness that renders the patient moderately or severely disabled before the brain insult.
- Patients that need an additional procedure e.g. cerebrospinal fluid shunting with cranioplasty in the same setting.
- History of central nervous system infection
- Craniectomy-related complications such as hemorrhage or surgical site infection requiring surgical intervention or deemed to affect patient's long-term cognitive outcome
- Claustrophobia or any other medical condition that prohibits the patient from undergo MRI scanning
- Patients who cannot understand spoken English or Chinese
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
No Intervention: "Late" cranioplasty
Subjects undergoing cranioplasty within 3 months after craniectomy.
|
|
Experimental: "Early" cranioplasty
Subjects undergoing cranioplasty beyond 3 months after craniectomy.
|
Subjects undergoing cranioplasty beyond 3 months after craniectomy.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Montreal Cognitive Assessment (MOCA)
Time Frame: 3-months
|
Minimum (worse): 0/30; Maximum (best) 30/30.
Higher values represent a better outcome.
|
3-months
|
Neurobehavioural Cognitive State Examination (NCSE)
Time Frame: 3-months
|
Multi-domain assessment involving: orientation, attention, registration, comprehension, repetition, naming, construction, calculation, similarities,judgement.
Stratification of each domain into mild, moderate and severe impairment.
The higher the number the better the outcome.
|
3-months
|
Rivermead Behavioural Memory Test (RBMT)
Time Frame: 3-months
|
3-months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Motor assessment
Time Frame: 3-months
|
Medical Research Council limb power
|
3-months
|
Modified Functional Ambulation Category (MFAC)
Time Frame: 3-months
|
7 ordinal scale assessment.
The lower the scale, the worse the ambulatory ability of the patient.
I: bed bound; 2: wheel-chair bound; 3: dependent walker; 4: Assisted walker; 5: Supervised walker; 6: Indoor walker; 7: Outdoor walker (patient can walk anywhere).
|
3-months
|
Quality of life assessment
Time Frame: 3-months
|
Short Form-36 (SF-36)
|
3-months
|
Psychological assessment
Time Frame: 3-months
|
Beck depression inventory (BDI)
|
3-months
|
Caregiver assessment
Time Frame: 3-months
|
Caregiver Strain Index
|
3-months
|
Caregiver
Time Frame: 3-months
|
Caregiver self-assessment questionnaire
|
3-months
|
MRI cerebral perfusion assessment
Time Frame: 3-months
|
Cerebral blood flow
|
3-months
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Calvin Mak, MBBS FRCS, Neurosurgery, Queen Elizabeth Hospital
Publications and helpful links
General Publications
- Halani SH, Chu JK, Malcolm JG, Rindler RS, Allen JW, Grossberg JA, Pradilla G, Ahmad FU. Effects of Cranioplasty on Cerebral Blood Flow Following Decompressive Craniectomy: A Systematic Review of the Literature. Neurosurgery. 2017 Aug 1;81(2):204-216. doi: 10.1093/neuros/nyx054.
- Bender A, Heulin S, Rohrer S, Mehrkens JH, Heidecke V, Straube A, Pfefferkorn T. Early cranioplasty may improve outcome in neurological patients with decompressive craniectomy. Brain Inj. 2013;27(9):1073-9. doi: 10.3109/02699052.2013.794972. Epub 2013 May 10.
- Ashayeri K, M Jackson E, Huang J, Brem H, Gordon CR. Syndrome of the Trephined: A Systematic Review. Neurosurgery. 2016 Oct;79(4):525-34. doi: 10.1227/NEU.0000000000001366.
- Malcolm JG, Rindler RS, Chu JK, Grossberg JA, Pradilla G, Ahmad FU. Complications following cranioplasty and relationship to timing: A systematic review and meta-analysis. J Clin Neurosci. 2016 Nov;33:39-51. doi: 10.1016/j.jocn.2016.04.017. Epub 2016 Aug 4.
- Xu H, Niu C, Fu X, Ding W, Ling S, Jiang X, Ji Y. Early cranioplasty vs. late cranioplasty for the treatment of cranial defect: A systematic review. Clin Neurol Neurosurg. 2015 Sep;136:33-40. doi: 10.1016/j.clineuro.2015.05.031. Epub 2015 May 29.
- Tsang AC, Hui VK, Lui WM, Leung GK. Complications of post-craniectomy cranioplasty: risk factor analysis and implications for treatment planning. J Clin Neurosci. 2015 May;22(5):834-7. doi: 10.1016/j.jocn.2014.11.021. Epub 2015 Mar 28.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- CCO-RCT
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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