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Article

Hydrocephalus and Cerebrospinal Fluid Analysis Following Severe Traumatic Brain Injury: Evaluation of a Prospective Cohort

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Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA
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Department of Neurological Surgery, University of California San Francisco, San Francisco, CA 94143, USA
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Department of Critical Care Medicine, Sunnybrook Health Sciences Center, University of Toronto, Toronto, ON M4N 3M5, Canada
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Neurotrauma Clinical Trials Center, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Tibor Hortobagyi
Neurol. Int. 2021, 13(4), 527-534; https://doi.org/10.3390/neurolint13040052
Received: 9 September 2021 / Revised: 11 October 2021 / Accepted: 12 October 2021 / Published: 19 October 2021
The development of hydrocephalus after severe traumatic brain injury (TBI) is an under-recognized healthcare phenomenon and can increase morbidity. The current study aims to characterize post-traumatic hydrocephalus (PTH) in a large cohort. Patients were prospectively enrolled age 16–80 years old with Glasgow Coma Scale (GCS) score 8. Demographics, GCS, Injury Severity Score (ISS), surgery, and cerebrospinal fluid (CSF) were analyzed. Outcomes were shunt failure and Glasgow Outcome Scale (GOS) at 6 and 12-months. Statistical significance was assessed at p < 0.05. In 402 patients, mean age was 38.0 ± 16.7 years and 315 (78.4%) were male. Forty (10.0%) patients developed PTH, with predominant injuries being subdural hemorrhage (36.4%) and diffuse axonal injury (36.4%). Decompressive hemicraniectomy (DHC) was associated with hydrocephalus (OR 3.62, 95% CI (1.62–8.07), p < 0.01). Eighteen (4.5%) patients had shunt failure and proximal obstruction was most common. Differences in baseline CSF cell count were associated with increased shunt failure. PTH was not associated with worse outcomes at 6 (p = 0.55) or 12 (p = 0.47) months. Hydrocephalus is a frequent sequela in 10.0% of patients, particularly after DHC. Shunt placement and revision procedures are common after severe TBI, within the first 4 months of injury and necessitates early recognition by the clinician. View Full-Text
Keywords: post-traumatic hydrocephalus; traumatic brain injury; ventriculoperitoneal shunt; decompressive hemicraniectomy; shunt failure; cerebrospinal fluid post-traumatic hydrocephalus; traumatic brain injury; ventriculoperitoneal shunt; decompressive hemicraniectomy; shunt failure; cerebrospinal fluid
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MDPI and ACS Style

Deng, H.; Goldschmidt, E.; Nwachuku, E.; Yue, J.K.; Angriman, F.; Wei, Z.; Agarwal, N.; Puccio, A.M.; Okonkwo, D.O. Hydrocephalus and Cerebrospinal Fluid Analysis Following Severe Traumatic Brain Injury: Evaluation of a Prospective Cohort. Neurol. Int. 2021, 13, 527-534. https://doi.org/10.3390/neurolint13040052

AMA Style

Deng H, Goldschmidt E, Nwachuku E, Yue JK, Angriman F, Wei Z, Agarwal N, Puccio AM, Okonkwo DO. Hydrocephalus and Cerebrospinal Fluid Analysis Following Severe Traumatic Brain Injury: Evaluation of a Prospective Cohort. Neurology International. 2021; 13(4):527-534. https://doi.org/10.3390/neurolint13040052

Chicago/Turabian Style

Deng, Hansen, Ezequiel Goldschmidt, Enyinna Nwachuku, John K. Yue, Federico Angriman, Zhishuo Wei, Nitin Agarwal, Ava M. Puccio, and David O. Okonkwo 2021. "Hydrocephalus and Cerebrospinal Fluid Analysis Following Severe Traumatic Brain Injury: Evaluation of a Prospective Cohort" Neurology International 13, no. 4: 527-534. https://doi.org/10.3390/neurolint13040052

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