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Post Traumatic Hydrocephalus in Indian Subpopulation: An Institutional Experience
Vikas Chandra Jha1, Neeraj Jha
1All India Institute of Medical Sciences, Department of Neurosurgery, Patna, India.
Turkish Neurosurgery
|March 24, 2021
Summary
Cerebrospinal fluid (CSF) diversion benefits post-traumatic hydrocephalus (PTH) patients with raised intracranial pressure (ICP). Minimizing risk factors like low Glasgow Coma Score (GCS) is crucial for those not benefiting from CSF diversion.
Area of Science:
- Neurosurgery
- Neurology
- Trauma Care
Background:
- Post-traumatic hydrocephalus (PTH) is a complication of severe head injury.
- Identifying patients who benefit from cerebrospinal fluid (CSF) diversion is critical for effective management.
Purpose of the Study:
- To identify patient subgroups with ventriculomegaly who benefit from CSF diversion procedures for post-traumatic hydrocephalus (PTH).
- To identify risk factors associated with the development of PTH to minimize its occurrence.
Main Methods:
- Analysis of 500 head injury cases with suspected PTH over 1.5 years.
- Patients categorized into three groups based on ventriculomegaly, periventricular lucency, and intracranial pressure (ICP).
- Assessment of treatment benefit from CSF diversion and identification of risk factors.
Main Results:
- Incidence of radiological PTH was 3.4%.
- Lower Glasgow Coma Score (GCS), decompressive craniotomy, and prolonged ventilation were significant risk factors for PTH.
- CSF diversion showed significantly better results in cases with high opening CSF pressure (≥15 mmHg).
- Decompressive craniotomy led to more shunt revisions compared to conservative management.
Conclusions:
- CSF diversion improves ventriculomegaly with raised ICP but not without it.
- Minimizing risk factors is key for PTH subgroups not suitable for CSF diversion.
- Judicious use of decompressive craniotomy and minimizing mechanical ventilation are recommended for severe head injuries.
