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Post-traumatic hydrocephalus.

C Licata1, L Cristofori, R Gambin

  • 1Department of Neurosurgery, City Hospital of Verona, Verona, Italy.

Journal of Neurosurgical Sciences
|December 4, 2001
PubMed
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Aggressive cerebrospinal fluid (CSF) shunting is necessary for post-traumatic hydrocephalus following severe head trauma. Internal shunts show favorable outcomes, even in comatose patients, highlighting the importance of surgical intervention.

Area of Science:

  • Neurosurgery
  • Trauma Surgery
  • Neurology

Background:

  • Distinguishing true post-traumatic hydrocephalus from brain atrophy is challenging, leading to varied incidence rates (0.7-29%).
  • Ventricular dilatation after severe head trauma (GCS <8) warrants investigation due to potential benefits of cerebrospinal fluid (CSF) shunting.

Purpose of the Study:

  • To evaluate the efficacy of CSF shunting in patients with post-traumatic hydrocephalus.
  • To analyze outcomes based on shunt type (internal vs. external) and patient condition.

Main Methods:

  • Retrospective analysis of 98 patients with severe head trauma treated with CSF shunting between 1972 and 1999.
  • Patients underwent either external (15 cases) or internal (83 cases) CSF shunting.
  • Data collected on patient demographics, trauma characteristics, hydrocephalus onset, and surgical outcomes.

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Main Results:

  • External shunts showed poor outcomes, with 87% mortality.
  • Internal shunts in 83 patients, many severely ill (75% in coma), resulted in 45% good recovery, 11% partial disability, 35% persistent coma, and 8% mortality.
  • Favorable outcomes were observed even in patients with coma or persistent coma.

Conclusions:

  • Post-traumatic hydrocephalus is a significant complication of severe head trauma that requires consideration.
  • Aggressive surgical management with CSF shunting is recommended for post-traumatic ventricular dilatation.
  • Internal CSF shunting offers a favorable prognosis, even in critically ill patients.