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Risk factors for the development of posttraumatic hydrocephalus after unilateral decompressive craniectomy in

Tsung-Ming Su1, Chu-Mei Lan2, Tsung-Han Lee1

  • 1Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No. 123 Dapi Road, Niaosong District, Kaohsiung City 83301, Taiwan.

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|March 5, 2019
PubMed

Insights

Older age and contralateral subdural hygroma (SDG) increase the risk of posttraumatic hydrocephalus (PTH) after decompressive craniectomy (DC) for traumatic brain injury (TBI). Early detection and management are crucial for these patients.

Area of Science:

  • Neurosurgery
  • Trauma Surgery
  • Neurology

Background:

  • Decompressive craniectomy (DC) is increasingly used for refractory intracranial hypertension in traumatic brain injury (TBI).
  • Complications of DC include subdural hygroma (SDG) and posttraumatic hydrocephalus (PTH).

Purpose of the Study:

  • To investigate the incidence and risk factors of PTH after unilateral DC in TBI patients.
  • To explore the relationship between SDG types and PTH development.

Main Methods:

  • Retrospective analysis of 143 TBI patients undergoing unilateral DC.
  • Stepwise logistic regression to identify independent risk factors for PTH.

Main Results:

  • PTH incidence was 30.1%.
  • Independent risk factors for PTH were older age (OR=1.036) and contralateral SDG (OR=5.613).
  • PTH was associated with significantly unfavorable outcomes (p < 0.0001).

Conclusions:

  • Older TBI patients with contralateral SDG after unilateral DC require close surveillance for early PTH detection.
  • Timely management of PTH is essential for improving outcomes in TBI patients.

Keywords:
Decompressive craniectomyPosttraumatic hydrocephalusSubdural hygromaTraumatic brain injury

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