Posttraumatic Hydrocephalus after Decompressive Craniectomy in 126 Patients with Severe Traumatic Brain Injury.
OBJECTIVE
Severe traumatic brain injuries (TBIs) occur frequently. In some of these patients decompressive craniectomy (DC) must be performed. Posttraumatic hydrocephalus (PTH) can develop after TBI further damaging the brain. DC is considered to be one of the causes of PTH. This study defines the incidence of PTH in TBI patients who underwent DC and tries to determine associated factors.


METHODS
We conducted a retrospective study (2009-2013) that included 126 patients with severe TBI and DC. The collected data were demographics, the craniectomy size, the presence or absence of hydrocephalus, the need for changing the opening pressure of the valve of the cerebrospinal fluid (CSF) shunt or replacing all or parts of the CSF shunt, and the interval between cranioplasty and shunt placement. We excluded patients with additional intraventricular hemorrhage and those with bilateral or bifrontal DC.


RESULTS
Ten of the 126 patients (7.9%) developed PTH and were treated with a CSF shunt. There was no statistical correlation between development of PTH and age or sex, but a statistically significant correlation between development of PTH and the size of DC.


CONCLUSIONS
Our study suggests that PTH development is multifactorial and shows that PTH is not that rare. We showed a correlation between craniectomy size and the incidence of PTH.
Department of Neurosurgery, University Hospital of Thesaly, Larissa, Thesaly, Greece.
George
G
Fotakopoulos
Department of Neurosurgery, University Hospital of Thesaly, Larissa, Thesaly, Greece.
Eleni
E
Tsianaka
Department of Neurosurgery, University Hospital of Thesaly, Larissa, Thesaly, Greece.
Giannis
G
Siasios
Department of Neurosurgery, University Hospital of Thesaly, Larissa, Thesaly, Greece.
Konstantinos
K
Vagkopoulos
Department of Neurosurgery, University Hospital of Thesaly, Larissa, Thesaly, Greece.
Kostas
K
Fountas
D000293:Adolescent; D000328:Adult; D000368:Aged; D000070642:Brain Injuries, Traumatic / Q000601:surgery*; D056424:Decompressive Craniectomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000453:epidemiology / Q000209:etiology*; D015994:Incidence; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D055815:Young Adult