title: Posttraumatic hydrocephalus: a clinical, neuroradiologic, and neuropsychologic assessment of long-term outcome.
abstract: OBJECTIVE
  To detect the clinical and radiologic characteristics of posttraumatic hydrocephalus (PTH), to define its prognostic value, and to assess the effects of shunt surgery.
  
  
  METHODS
  Correlational study on a prospective cohort.
  
  
  METHODS
  Brain injury rehabilitation center.
  
  
  METHODS
  One hundred forty patients with severe traumatic brain injury (TBI) referred to an inpatient intensive rehabilitation unit of primary care in a university-based system.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  The Glasgow Outcome Scale (GOS), Disability Rating Scale (DRS), FIM instrument, and Neurobehavioural Rating Scale (NRS), as well as single-photon emission computed tomography (SPECT) and magnetic resonance imaging.
  
  
  RESULTS
  PTH was found in 45% of patients. Risk factors for PTH were as follows: age (P<.04), duration of coma (P<.0001), and decompressive craniectomy (P<.0001). PTH correlated with the degree of hypoperfusion in the temporal lobes (P<.001). Patients who showed clinical deterioration improved after surgery. PTH correlated significantly with GOS, DRS, FIM, and NRS (P<.0001) 1 year after the trauma, and it influenced the appearance of posttraumatic epilepsy (P<.02).
  
  
  CONCLUSIONS
  PTH concerns about 50% of patients with severe TBI. It influences functional and behavioral outcome and the appearance of posttraumatic epilepsy. The selection of patients for surgery can be defined principally on a clinical basis. SPECT may be helpful for differentiating ventricular enlargement due to cortical atrophy and hydrocephalus.
authors.affiliation: Department of Neurology, San Giovanni Bosco Hospital, Turin, Italy. mazzini.l@libero.it
authors.forename: Letizia
authors.initials: L
authors.lastname: Mazzini
authors.forename: Riccardo
authors.initials: R
authors.lastname: Campini
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Angelino
authors.forename: Felice
authors.initials: F
authors.lastname: Rognone
authors.forename: Ilaria
authors.initials: I
authors.lastname: Pastore
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Oliveri
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000150:complications*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D006849:Hydrocephalus / Q000145:classification / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D015899:Tomography, Emission-Computed, Single-Photon