Turkish Neurosurgery
Post traumatic hydrocephalus in Indian subpopulation,an institutional experience.
vikas jha1, Neeraj Jha1
1AIIMS,Patna, Neurosurgery, Patna,
DOI: 10.5137/1019-5149.JTN.30032-20.2

Aim:Cerebrospinal fluid (CSF) diversion procedures have mixed results in PTH; therefore, it is pertinent to identify cases of PTH who will benefit from the procedure and search the factors responsible for it to minimize its occurrence.Material and Methods:500 cases included in this retrospective observational study were assigned to one of three groups: Group 1 had ventriculomegaly with periventricular lucency (PVL), and raised intracranial pressure (ICP) 2.1% (10/500). Group 2 had ventriculomegaly with PVL, and normal opening pressure 1.75% (7/500) and Group three had no ventriculomegaly 95.75% (483/500). Results:The incidence of radiological PTH in this study was 3.4% (17/500), and it developed after an average interval of 16.43 ± 23.7 (SD) in Group 1 and 19.76 ± 8.9 (SD) weeks in Group 2. Lower Glasgow Coma Score (GCS) (P < 0.001), decompressive craniotomy (p < 0.001) and requirement for prolonged ventilatory support (p < 0.001) were significantly associated with the development of PTH. Significantly better results were found in cases with PTH and high opening CSF pressure (≥ 15 mmHg) on Lumbar puncture (P < 0.001). Decompressive craniotomy cases required significantly more shunt revisions compared to conservatively managed cases (P < 0.05).Conclusion:CSF diversion procedures help to improve ventriculomegaly cases with documented evidence of raised ICP but not in cases without raised ICP. The subgroup of PTH, which cannot be treated by CSF diversion procedures decompressive craniotomy should be used judiciously. The duration of mechanical ventilation should be minimized and combined with necessary measures to improve GCS.

Corresponding author : vikas jha