One-year outcome of patients with posttraumatic hydrocephalus treated by lumboperitoneal shunt: an observational...

Lumboperitoneal shunt (LPS) attracts increasing number of research interest in the treatment of hydrocephalus due to minimal invasiveness. However, the outcome of LPS-treated posttraumatic hydrocephalus (PTH) is poorly learnt, remaining unknown to date.

We retrospectively analyzed adult patients with PTH treated by LPS in our department between May 2013 and Apr 2017. Baseline characteristics, preoperative clinical features, symptomatic and imageologic improvement, and postoperative complications were synchronously investigated. All patients were followed up to 1 year after LPS to determine the shunt outcome and quality of life. Furthermore, the Kaplan-Meier curve was drawn and binary logistic regression analysis was used to identify the possible predictive factors of shunt failure.

Thirty-eight eligible patients were included in our study. Five days after LPS, chronic hydrocephalus scores (CHS; 10.26 ± 5.17 vs 5.21 ± 3.75; P < 0.001) and Evans index (0.36 ± 0.06 vs 0.28 ± 0.06; P < 0.001) were significantly improved with statistical difference. The overall incidence of complications was 50% (19 patients) while hydrocephalus-associated death or shunt failure was not observed immediately after LPS. According to the 1-year follow-up, most of the patients obtained good prognosis while 16 patients (42.1%) were failed, including 15 patients (39.5%) underwent shunt revision and one patient (2.6%) was dead ascribing to shunt malfunction. However, we failed to screen out any factors contributing to LPS failure.

To sum up, we have, for the first time, demonstrated that LPS could be a potential option to treat PTH.