417 Factors Associated with the Development of Post-Traumatic Hydrocephalus Following a Decompressive Craniectomy: A Single Centre Experience

Abstract

Abstract Introduction A decompressive craniectomy (DC) is a surgical procedure sometimes utilised to manage refractory intracranial hypertension following severe traumatic brain injury (sTBI). Previous studies have established a relationship between DC and post-traumatic hydrocephalus (PTH). This study aimed to identify the factors responsible for developing shunt-amenable post-traumatic hydrocephalus in patients who underwent DC following sTBI. Method A review of a prospectively collected database of all patients admitted with severe TBI in a tertiary neurosurgical centre in northwest England between January 2012 and May 2022 was performed. Post-traumatic hydrocephalus was defined as evidence of progressive ventricular dilatation, clinical deterioration, and/or the eventual need for CSF diversion (i.e. a ventriculoperitoneal shunt). Statistical analysis was carried out using IBM SPSS vs 28.0.1. Results 65 patients met the eligibility criteria and were included in the study. The mean age of the PTH group was 31.38+/-14.67, while the mean age of the non-PTH group was slightly higher at 39.96 +/- 14.85. No statistically significant difference was observed between the two groups' mechanisms of traumatic injury (MOI) (P = 0.945). Of the predictors investigated, cerebellar hematoma (and contusions) was significantly associated with post-traumatic hydrocephalus (p = 0.006). Conclusions This study concludes that cerebellar hematoma (and contusions) are associated with developing post-traumatic hydrocephalus in patients undergoing decompressive craniectomy.