Related Experiment Video
Updated: Dec 21, 2025
A Pediatric Concussion Model in Mice: Closed Head Injury with Long-Term Disorders (CHILD)
Published on: February 7, 2025
Risk Factors for the Development of Post-Traumatic Hydrocephalus in Children
Aladine A Elsamadicy1, Andrew B Koo1, Victor Lee1
1Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut, USA.
Insights
Pediatric traumatic brain injury (TBI) patients developing posttraumatic hydrocephalus (PTH) were younger and had increased risks with longer unconsciousness and complications like hemorrhage. Older children had decreased PTH risk.
Area of Science:
- Pediatric Traumatology
- Neurosurgery
- Epidemiology
Background:
- Traumatic brain injury (TBI) is a significant cause of morbidity in children.
- Posttraumatic hydrocephalus (PTH) is a serious complication following TBI, particularly in pediatric populations.
- Understanding risk factors for PTH is crucial for timely intervention and improved outcomes.
Purpose of the Study:
- To investigate demographic, hospital, and inpatient risk factors associated with posttraumatic hydrocephalus (PTH) development in pediatric patients after traumatic brain injury (TBI).
- To identify specific patient characteristics and clinical events that increase or decrease the risk of PTH in children and adolescents.
Main Methods:
- Utilized the Nationwide Emergency Department Sample database (2010-2014).
- Identified pediatric patients (<21 years) with primary TBI and secondary PTH diagnoses using ICD-9-CM codes.
- Performed multivariate regression analysis to determine independent risk factors for PTH development.
Main Results:
- Out of 1,244,087 TBI patients, 930 (0.07%) developed PTH.
- Older age groups (6-20 years) showed a decreased risk of PTH compared to younger children (0-5 years).
- Increased risk of PTH was associated with extended loss of consciousness, respiratory complications, hemorrhage, thromboembolic events, and neurologic complications.
Conclusions:
- Demographic, hospital, and clinical factors significantly influence the development of PTH in pediatric TBI patients.
- Age, duration of unconsciousness, and specific complications are key predictors of PTH risk.
- This study highlights the importance of comprehensive monitoring and management of pediatric TBI patients at risk for hydrocephalus.
Objective:
The aim of this study was to investigate the national impact of demographic, hospital, and inpatient risk factors on posttraumatic hydrocephalus (PTH) development in pediatric patients who presented to the emergency department after a traumatic brain injury (TBI).
Methods:
The Nationwide Emergency Department Sample database 2010-2014 was queried. Patients (<21 years old) with a primary diagnosis of TBI and subsequent secondary diagnosis of PTH were identified using the International Classification of Diseases, Ninth Revision, Clinical Modification coding system.
Results:
We identified 1,244,087 patients who sustained TBI, of whom 930 (0.07%) developed PTH. The rates of subdural hemorrhage and subarachnoid hemorrhage were both significantly higher for the PTH cohort. On multivariate regression, age 6-10 years (odds ratio [OR], 0.6; 95% confidence interval [CI], 0.38-0.93; P = 0.022), 11-15 years (OR, 0.32; 95% CI, 0.21-0.48; P < 0.0001), and 16-20 years (OR, 0.24; 95% CI, 0.15-0.37; P < 0.0001) were independently associated with decreased risk of developing hydrocephalus, compared with ages 0-5 years. Extended loss of consciousness with baseline return and extended loss of consciousness without baseline return were independently associated with increased risk of developing hydrocephalus. Respiratory complication (OR, 28.35; 95% CI, 15.75-51.05; P < 0.0001), hemorrhage (OR, 37.12; 95% CI, 4.79-287.58; P = 0.0001), thromboembolic (OR, 8.57; 95% CI, 1.31-56.19; P = 0.025), and neurologic complication (OR, 64.64; 95% CI, 1.39-3010.2; P = 0.033) were all independently associated with increased risk of developing hydrocephalus.
Conclusions:
Our study using the Nationwide Emergency Department Sample database shows that various demographic, hospital, and clinical risk factors are associated with the development of hydrocephalus after traumatic brain injury.
Related Concept Videos
01:27Post-traumatic Stress Disorder
Symptoms and Behavioral Manifestations
A spectrum of distressing symptoms characterizes PTSD. Recurrent flashbacks, where individuals involuntarily relive traumatic events,...
01:30Attention-Deficit/Hyperactivity Disorder
Diagnostic Criteria and Symptoms
To diagnose ADHD, symptoms must manifest before age 12 and be evident across multiple settings....
01:29Psychological and Sociocultural Causes of Schizophrenia