title: [Multiplicity and prevention for patients with hydrocephalus secondary to severe traumatic brain injury after surgery].
abstract: OBJECTIVE
  To investigate the factors for hydrocephalus secondary to severe traumatic brain injury after surgery, and to explore a new theory and guideline for clinical early prevention and treatment for hydrocephalus.
  
  
  METHODS
  The clinical data regarding 107 patients with severe traumatic brain injury, who were admitted to our hospital from June 2010 to June 2013, were analyzed. Logistic multi-factor regression was used to analyze the different factors including ages, gender, the Glasgow coma scale (GCS) score before or after surgery, the situation of ventricular system bleeding secondary to surgery, the situation of midbrain aqueduct and ambient cistern before or after surgery, the relationship between early lumbar puncture and the hydrocephalus. The risk and protective factors for postoperative hydrocephalus were discussed.
  
  
  RESULTS
  The results showed that patients with low GCS score in pre/postoperative (OR=0.099, 95%CI: 0.028-0.350)/(OR=0.088, 95%CI: 0.012-0.649), ventricular system bleeding in postoperative (OR=0.168, 95%CI: 0.029-0.979) and dim CT image for midbrain aqueduct and ambient cistern (OR=0.134, 95%CI: 0.038-0.473)/(OR=0.221, 95%CI: 0.055-0.882) are risk factors. Whereas lumbar puncture (OR=75.885, 95%CI: 9.612-599.122) is a protective factor for postoperative hydrocephalus in STBI patients. The secondary hydrocephalus was mainly occurred in 2 weeks and 2 weeks to 3 months after operation. The incidence of the control group that occurred secondary hydrocephalus is higher than that of the lumbar puncture group (P<0.05). The secondary hydrocephalus were mainly occurred in 2 weeks and 2 weeks to 3 months after operation, with no statistical significance between the 2 groups after 3 months of operation (P>0.05).
  
  
  CONCLUSIONS
  For patients with stable vital signs, early lumbar puncture could significantly reduce the incidence of secondary hydrocephalus in acute and subacute stage after severe traumatic brain injury.
authors.affiliation: Clinical Medicine School, Ningxia Medical University, Yinchuan 750004, China.
authors.forename: Ke
authors.initials: K
authors.lastname: Cao
authors.affiliation: Clinical Medicine School, Ningxia Medical University, Yinchuan 750004, China.
authors.forename: Guangran
authors.initials: G
authors.lastname: Meng
authors.affiliation: Department of Neurosurgery, General Hospital of Ningxia Medical University, Yinchuan 750004, China.
authors.forename: Zongzheng
authors.initials: Z
authors.lastname: Li
authors.affiliation: School of Public Health, Ningxia Medical University, Yinchuan 750004, China.
authors.forename: Faxuan
authors.initials: F
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, General Hospital of Ningxia Medical University, Yinchuan 750004, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Ma
mesh_terms: D001930:Brain Injuries / Q000150:complications*; D002552:Cerebral Ventricles / Q000503:physiopathology; D015600:Glasgow Coma Scale; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology* / Q000517:prevention & control*; D015994:Incidence; D016015:Logistic Models; D012307:Risk Factors; D013129:Spinal Puncture; D016896:Treatment Outcome