Risk factors for post-traumatic hydrocephalus following decompressive craniectomy
Background Post-traumatic hydrocephalus (PTH) is one of the main complications of decompressive craniectomy (DC) after traumatic brain injury (TBI). Then, the recognition of risk factors and subsequent prompt diagnosis and treatment of PTH can improve the outcome of these patients. The purpose of th...
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| Veröffentlicht in: | Acta neurochirurgica 2018-09, Vol.160 (9), p.1691-1698 |
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| creator | Nasi, Davide Gladi, Maurizio Di Rienzo, Alessandro di Somma, Lucia Moriconi, Elisa Iacoangeli, Maurizio Dobran, Mauro |
| description | Background
Post-traumatic hydrocephalus (PTH) is one of the main complications of decompressive craniectomy (DC) after traumatic brain injury (TBI). Then, the recognition of risk factors and subsequent prompt diagnosis and treatment of PTH can improve the outcome of these patients. The purpose of this study was to identify factors associated with the development of PTH requiring surgical treatment in patients undergoing DC for TBI.
Methods
In this study, we collected the data of 190 patients (149 males and 41 females), who underwent DC for TBI in our Center. Then we analyzed the type of surgical treatment for all patients affected by PTH and the risk factors associated with the development of PTH.
Results
Post-traumatic hydrocephalus (PTH) developed in 37 patients out of 130 alive 30 days after DC (28.4%). The development of PTH required ventriculoperitoneal shunt (VPS) in 34 patients out of 37 (91.9%), while, in the remaining 3 patients, cerebrospinal fluid hydrodynamic (CSF) disturbances resolved after urgent cranioplasty and temporary external lumbar drain. Multivariate analysis showed that the presence of interhemispheric hygroma (
p
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| doi_str_mv | 10.1007/s00701-018-3639-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2078581541</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2078581541</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-9d7b2975b85b5eb08015f7c04c73e5d5307401bf0fd56940c2f87e97c03bb72f3</originalsourceid><addsrcrecordid>eNp1kF1LwzAUhoMobk5_gDdS8Mab6EnSLO2lDL9gIIpehzZNts62qUmr7N-b0qkgeHOScJ7zJnkQOiVwSQDElQ8FCAaSYDZnKYY9NIU0pjgU2A97CN05nScTdOT9JpyoiNkhmjAAHgvKp-jpufRvkclUZ52PjHVRa32HO5f1ddaVKlpvC2eVbtdZ1Q9AVdnPsllFhVa2bp32vvzQkXJZU-oQUm-P0YHJKq9PdusMvd7evCzu8fLx7mFxvcSKCdrhtBA5TQXPE55znUMChBuhIFaCaV5wBiIGkhswBZ-H7yhqEqHTQLA8F9SwGboYc1tn33vtO1mXXumqyhptey8piIQnhMckoOd_0I3tXRNeN1DBQ8yYCBQZKeWs904b2bqyztxWEpCDbzn6lsG3HHxLCDNnu-Q-r3XxM_EtOAB0BHxoNSvtfq_-P_ULrZqK4Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2077254337</pqid></control><display><type>article</type><title>Risk factors for post-traumatic hydrocephalus following decompressive craniectomy</title><source>SpringerLink Journals</source><creator>Nasi, Davide ; Gladi, Maurizio ; Di Rienzo, Alessandro ; di Somma, Lucia ; Moriconi, Elisa ; Iacoangeli, Maurizio ; Dobran, Mauro</creator><creatorcontrib>Nasi, Davide ; Gladi, Maurizio ; Di Rienzo, Alessandro ; di Somma, Lucia ; Moriconi, Elisa ; Iacoangeli, Maurizio ; Dobran, Mauro</creatorcontrib><description>Background
Post-traumatic hydrocephalus (PTH) is one of the main complications of decompressive craniectomy (DC) after traumatic brain injury (TBI). Then, the recognition of risk factors and subsequent prompt diagnosis and treatment of PTH can improve the outcome of these patients. The purpose of this study was to identify factors associated with the development of PTH requiring surgical treatment in patients undergoing DC for TBI.
Methods
In this study, we collected the data of 190 patients (149 males and 41 females), who underwent DC for TBI in our Center. Then we analyzed the type of surgical treatment for all patients affected by PTH and the risk factors associated with the development of PTH.
Results
Post-traumatic hydrocephalus (PTH) developed in 37 patients out of 130 alive 30 days after DC (28.4%). The development of PTH required ventriculoperitoneal shunt (VPS) in 34 patients out of 37 (91.9%), while, in the remaining 3 patients, cerebrospinal fluid hydrodynamic (CSF) disturbances resolved after urgent cranioplasty and temporary external lumbar drain. Multivariate analysis showed that the presence of interhemispheric hygroma (
p
< 0.001) and delayed cranioplasty (3 months after DC) (
p
< 0.001) was significantly associated with the need for a VPS or other surgical procedure for PTH. Finally, among the 130 patients alive after 30 days from DC, PTH was associated with unfavorable outcome as measured by the 6-month Glasgow Outcome Scale score (
p
< 0.0001).
Conclusions
Our results showed that delayed cranial reconstruction was associated with an increasing rate of PTH after DC. The presence of an interhemispheric hygroma was an independent predictive radiological sign of PTH in decompressed patients for severe TBI.</description><identifier>ISSN: 0001-6268</identifier><identifier>EISSN: 0942-0940</identifier><identifier>DOI: 10.1007/s00701-018-3639-0</identifier><identifier>PMID: 30054725</identifier><language>eng</language><publisher>Vienna: Springer Vienna</publisher><subject>Brain trauma ; Cerebral hemispheres ; Cerebrospinal fluid ; Complications ; Females ; Hydrocephalus ; Interventional Radiology ; Males ; Medicine ; Medicine & Public Health ; Minimally Invasive Surgery ; Multivariate analysis ; Neurology ; Neuroradiology ; Neurosurgery ; Original Article - Brain trauma ; Parathyroid hormone ; Patients ; Risk factors ; Skull ; Surgical Orthopedics ; Traumatic brain injury ; Ventriculoperitoneal shunt</subject><ispartof>Acta neurochirurgica, 2018-09, Vol.160 (9), p.1691-1698</ispartof><rights>Springer-Verlag GmbH Austria, part of Springer Nature 2018</rights><rights>Acta Neurochirurgica is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-9d7b2975b85b5eb08015f7c04c73e5d5307401bf0fd56940c2f87e97c03bb72f3</citedby><cites>FETCH-LOGICAL-c372t-9d7b2975b85b5eb08015f7c04c73e5d5307401bf0fd56940c2f87e97c03bb72f3</cites><orcidid>0000-0002-7357-7455</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00701-018-3639-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00701-018-3639-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30054725$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nasi, Davide</creatorcontrib><creatorcontrib>Gladi, Maurizio</creatorcontrib><creatorcontrib>Di Rienzo, Alessandro</creatorcontrib><creatorcontrib>di Somma, Lucia</creatorcontrib><creatorcontrib>Moriconi, Elisa</creatorcontrib><creatorcontrib>Iacoangeli, Maurizio</creatorcontrib><creatorcontrib>Dobran, Mauro</creatorcontrib><title>Risk factors for post-traumatic hydrocephalus following decompressive craniectomy</title><title>Acta neurochirurgica</title><addtitle>Acta Neurochir</addtitle><addtitle>Acta Neurochir (Wien)</addtitle><description>Background
Post-traumatic hydrocephalus (PTH) is one of the main complications of decompressive craniectomy (DC) after traumatic brain injury (TBI). Then, the recognition of risk factors and subsequent prompt diagnosis and treatment of PTH can improve the outcome of these patients. The purpose of this study was to identify factors associated with the development of PTH requiring surgical treatment in patients undergoing DC for TBI.
Methods
In this study, we collected the data of 190 patients (149 males and 41 females), who underwent DC for TBI in our Center. Then we analyzed the type of surgical treatment for all patients affected by PTH and the risk factors associated with the development of PTH.
Results
Post-traumatic hydrocephalus (PTH) developed in 37 patients out of 130 alive 30 days after DC (28.4%). The development of PTH required ventriculoperitoneal shunt (VPS) in 34 patients out of 37 (91.9%), while, in the remaining 3 patients, cerebrospinal fluid hydrodynamic (CSF) disturbances resolved after urgent cranioplasty and temporary external lumbar drain. Multivariate analysis showed that the presence of interhemispheric hygroma (
p
< 0.001) and delayed cranioplasty (3 months after DC) (
p
< 0.001) was significantly associated with the need for a VPS or other surgical procedure for PTH. Finally, among the 130 patients alive after 30 days from DC, PTH was associated with unfavorable outcome as measured by the 6-month Glasgow Outcome Scale score (
p
< 0.0001).
Conclusions
Our results showed that delayed cranial reconstruction was associated with an increasing rate of PTH after DC. The presence of an interhemispheric hygroma was an independent predictive radiological sign of PTH in decompressed patients for severe TBI.</description><subject>Brain trauma</subject><subject>Cerebral hemispheres</subject><subject>Cerebrospinal fluid</subject><subject>Complications</subject><subject>Females</subject><subject>Hydrocephalus</subject><subject>Interventional Radiology</subject><subject>Males</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Minimally Invasive Surgery</subject><subject>Multivariate analysis</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosurgery</subject><subject>Original Article - Brain trauma</subject><subject>Parathyroid hormone</subject><subject>Patients</subject><subject>Risk factors</subject><subject>Skull</subject><subject>Surgical Orthopedics</subject><subject>Traumatic brain injury</subject><subject>Ventriculoperitoneal shunt</subject><issn>0001-6268</issn><issn>0942-0940</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNp1kF1LwzAUhoMobk5_gDdS8Mab6EnSLO2lDL9gIIpehzZNts62qUmr7N-b0qkgeHOScJ7zJnkQOiVwSQDElQ8FCAaSYDZnKYY9NIU0pjgU2A97CN05nScTdOT9JpyoiNkhmjAAHgvKp-jpufRvkclUZ52PjHVRa32HO5f1ddaVKlpvC2eVbtdZ1Q9AVdnPsllFhVa2bp32vvzQkXJZU-oQUm-P0YHJKq9PdusMvd7evCzu8fLx7mFxvcSKCdrhtBA5TQXPE55znUMChBuhIFaCaV5wBiIGkhswBZ-H7yhqEqHTQLA8F9SwGboYc1tn33vtO1mXXumqyhptey8piIQnhMckoOd_0I3tXRNeN1DBQ8yYCBQZKeWs904b2bqyztxWEpCDbzn6lsG3HHxLCDNnu-Q-r3XxM_EtOAB0BHxoNSvtfq_-P_ULrZqK4Q</recordid><startdate>20180901</startdate><enddate>20180901</enddate><creator>Nasi, Davide</creator><creator>Gladi, Maurizio</creator><creator>Di Rienzo, Alessandro</creator><creator>di Somma, Lucia</creator><creator>Moriconi, Elisa</creator><creator>Iacoangeli, Maurizio</creator><creator>Dobran, Mauro</creator><general>Springer Vienna</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7357-7455</orcidid></search><sort><creationdate>20180901</creationdate><title>Risk factors for post-traumatic hydrocephalus following decompressive craniectomy</title><author>Nasi, Davide ; Gladi, Maurizio ; Di Rienzo, Alessandro ; di Somma, Lucia ; Moriconi, Elisa ; Iacoangeli, Maurizio ; Dobran, Mauro</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-9d7b2975b85b5eb08015f7c04c73e5d5307401bf0fd56940c2f87e97c03bb72f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Brain trauma</topic><topic>Cerebral hemispheres</topic><topic>Cerebrospinal fluid</topic><topic>Complications</topic><topic>Females</topic><topic>Hydrocephalus</topic><topic>Interventional Radiology</topic><topic>Males</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Minimally Invasive Surgery</topic><topic>Multivariate analysis</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Neurosurgery</topic><topic>Original Article - Brain trauma</topic><topic>Parathyroid hormone</topic><topic>Patients</topic><topic>Risk factors</topic><topic>Skull</topic><topic>Surgical Orthopedics</topic><topic>Traumatic brain injury</topic><topic>Ventriculoperitoneal shunt</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nasi, Davide</creatorcontrib><creatorcontrib>Gladi, Maurizio</creatorcontrib><creatorcontrib>Di Rienzo, Alessandro</creatorcontrib><creatorcontrib>di Somma, Lucia</creatorcontrib><creatorcontrib>Moriconi, Elisa</creatorcontrib><creatorcontrib>Iacoangeli, Maurizio</creatorcontrib><creatorcontrib>Dobran, Mauro</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Acta neurochirurgica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nasi, Davide</au><au>Gladi, Maurizio</au><au>Di Rienzo, Alessandro</au><au>di Somma, Lucia</au><au>Moriconi, Elisa</au><au>Iacoangeli, Maurizio</au><au>Dobran, Mauro</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk factors for post-traumatic hydrocephalus following decompressive craniectomy</atitle><jtitle>Acta neurochirurgica</jtitle><stitle>Acta Neurochir</stitle><addtitle>Acta Neurochir (Wien)</addtitle><date>2018-09-01</date><risdate>2018</risdate><volume>160</volume><issue>9</issue><spage>1691</spage><epage>1698</epage><pages>1691-1698</pages><issn>0001-6268</issn><eissn>0942-0940</eissn><abstract>Background
Post-traumatic hydrocephalus (PTH) is one of the main complications of decompressive craniectomy (DC) after traumatic brain injury (TBI). Then, the recognition of risk factors and subsequent prompt diagnosis and treatment of PTH can improve the outcome of these patients. The purpose of this study was to identify factors associated with the development of PTH requiring surgical treatment in patients undergoing DC for TBI.
Methods
In this study, we collected the data of 190 patients (149 males and 41 females), who underwent DC for TBI in our Center. Then we analyzed the type of surgical treatment for all patients affected by PTH and the risk factors associated with the development of PTH.
Results
Post-traumatic hydrocephalus (PTH) developed in 37 patients out of 130 alive 30 days after DC (28.4%). The development of PTH required ventriculoperitoneal shunt (VPS) in 34 patients out of 37 (91.9%), while, in the remaining 3 patients, cerebrospinal fluid hydrodynamic (CSF) disturbances resolved after urgent cranioplasty and temporary external lumbar drain. Multivariate analysis showed that the presence of interhemispheric hygroma (
p
< 0.001) and delayed cranioplasty (3 months after DC) (
p
< 0.001) was significantly associated with the need for a VPS or other surgical procedure for PTH. Finally, among the 130 patients alive after 30 days from DC, PTH was associated with unfavorable outcome as measured by the 6-month Glasgow Outcome Scale score (
p
< 0.0001).
Conclusions
Our results showed that delayed cranial reconstruction was associated with an increasing rate of PTH after DC. The presence of an interhemispheric hygroma was an independent predictive radiological sign of PTH in decompressed patients for severe TBI.</abstract><cop>Vienna</cop><pub>Springer Vienna</pub><pmid>30054725</pmid><doi>10.1007/s00701-018-3639-0</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-7357-7455</orcidid></addata></record> |
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| source | SpringerLink Journals |
| subjects | Brain trauma Cerebral hemispheres Cerebrospinal fluid Complications Females Hydrocephalus Interventional Radiology Males Medicine Medicine & Public Health Minimally Invasive Surgery Multivariate analysis Neurology Neuroradiology Neurosurgery Original Article - Brain trauma Parathyroid hormone Patients Risk factors Skull Surgical Orthopedics Traumatic brain injury Ventriculoperitoneal shunt |
| title | Risk factors for post-traumatic hydrocephalus following decompressive craniectomy |
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