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Updated: May 20, 2026

Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus

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Surgery for post-traumatic hydrocephalus: lessons, challenges and future directions.

Niccolò Neri¹, Arianna Vignaroli¹, Giorgio Palandri²

¹Department of Neurosurgery, Istituto delle Scienze Neurologiche di Bologna IRCCS Ospedale Bellaria, University of Bologna, Bologna, Italy.

Frontiers in Neurology

|April 27, 2026

Summary

Post-traumatic hydrocephalus (PTH) management involves various surgical options like shunting, with programmable valves preferred. Further research is needed to establish clear guidelines for optimal patient outcomes after traumatic brain injury (TBI).

Keywords:

cranioplasty decompressive craniectomy neurotrauma post-traumatic hydrocephalus shunt valve

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Area of Science:

Neurosurgery
Neurology
Traumatic Brain Injury Research

Background:

Post-traumatic hydrocephalus (PTH) is a frequent complication of traumatic brain injury (TBI), often underdiagnosed and undertreated.
Early intervention is crucial for neurological recovery, but management strategies lack definitive consensus.
Up to one-third of TBI patients may require intervention for PTH.

Purpose of the Study:

To review and synthesize current evidence on the surgical management of PTH.
To highlight the strengths and limitations of various surgical options for PTH.
To inform therapeutic decision-making and operative techniques in PTH.

Main Methods:

Comprehensive literature search of studies on surgical management of PTH.
Inclusion of retrospective and prospective series, comparative analyses, and reviews.
Focus on evidence from recent decades.

Main Results:

Ventriculoperitoneal shunting (VPS) is common, with lumboperitoneal shunting (LPS) and ventriculoatrial shunts (VAS) as alternatives.
Programmable valves are preferred over fixed-pressure systems due to fewer complications.
Endoscopic third ventriculostomy (ETV) shows potential but requires further long-term efficacy assessment.
Simultaneous cranioplasty and shunting evidence is contradictory; outcomes vary widely based on patient and injury characteristics.

Conclusions:

PTH management has advanced, but consensus on diagnostic and therapeutic indications remains elusive.
Prospective, multicenter trials are essential for refining surgical decision-making and improving outcomes.
Further research is needed to establish firm guidelines for PTH treatment.