OBJECTIVES: To detect the clinical and radiologic characteristics of posttraumatic hydrocephalus (PTH), to define its prognostic value, and to assess the effects of shunt surgery. DESIGN: Correlational study on a prospective cohort. SETTING: Brain injury rehabilitation center. PARTICIPANTS: One hundred forty patients with severe traumatic brain injury (TBI) referred to an inpatient intensive rehabilitation unit of primary care in a university-based system. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The Glasgow Outcome Scale (GOS), Disability Rating Scale (DRS), FIM instrument, and Neurobehavioural Rating Scale (NRS), as well as single-photon emission computed tomography (SPECT) and magnetic resonance imaging. RESULTS: PTH was found in 45% of patients. Risk factors for PTH were as follows: age (P<.04), duration of coma (P<.0001), and decompressive craniectomy (P<.0001). PTH correlated with the degree of hypoperfusion in the temporal lobes (P<.001). Patients who showed clinical deterioration improved after surgery. PTH correlated significantly with GOS, DRS, FIM, and NRS (P<.0001) 1 year after the trauma, and it influenced the appearance of posttraumatic epilepsy (P<.02). CONCLUSIONS: PTH concerns about 50% of patients with severe TBI. It influences functional and behavioral outcome and the appearance of posttraumatic epilepsy. The selection of patients for surgery can be defined principally on a clinical basis. SPECT may be helpful for differentiating ventricular enlargement due to cortical atrophy and hydrocephalus.
OBJECTIVES: To detect the clinical and radiologic characteristics of posttraumatic hydrocephalus (PTH), to define its prognostic value, and to assess the effects of shunt surgery. DESIGN: Correlational study on a prospective cohort. SETTING:Brain injury rehabilitation center. PARTICIPANTS: One hundred forty patients with severe traumatic brain injury (TBI) referred to an inpatient intensive rehabilitation unit of primary care in a university-based system. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The Glasgow Outcome Scale (GOS), Disability Rating Scale (DRS), FIM instrument, and Neurobehavioural Rating Scale (NRS), as well as single-photon emission computed tomography (SPECT) and magnetic resonance imaging. RESULTS: PTH was found in 45% of patients. Risk factors for PTH were as follows: age (P<.04), duration of coma (P<.0001), and decompressive craniectomy (P<.0001). PTH correlated with the degree of hypoperfusion in the temporal lobes (P<.001). Patients who showed clinical deterioration improved after surgery. PTH correlated significantly with GOS, DRS, FIM, and NRS (P<.0001) 1 year after the trauma, and it influenced the appearance of posttraumatic epilepsy (P<.02). CONCLUSIONS: PTH concerns about 50% of patients with severe TBI. It influences functional and behavioral outcome and the appearance of posttraumatic epilepsy. The selection of patients for surgery can be defined principally on a clinical basis. SPECT may be helpful for differentiating ventricular enlargement due to cortical atrophy and hydrocephalus.
Authors: D M Little; M F Kraus; J Joseph; E K Geary; T Susmaras; X J Zhou; N Pliskin; P B Gorelick Journal: Neurology Date: 2010-01-20 Impact factor: 9.910
Authors: Franck Amyot; David B Arciniegas; Michael P Brazaitis; Kenneth C Curley; Ramon Diaz-Arrastia; Amir Gandjbakhche; Peter Herscovitch; Sidney R Hinds; Geoffrey T Manley; Anthony Pacifico; Alexander Razumovsky; Jason Riley; Wanda Salzer; Robert Shih; James G Smirniotopoulos; Derek Stocker Journal: J Neurotrauma Date: 2015-09-30 Impact factor: 5.269
Authors: Sandy R Shultz; Mujun Sun; David K Wright; Rhys D Brady; Shijie Liu; Sinead Beynon; Shannon F Schmidt; Andrew H Kaye; John A Hamilton; Terence J O'Brien; Brian L Grills; Stuart J McDonald Journal: J Cereb Blood Flow Metab Date: 2015-04-08 Impact factor: 6.200
Authors: Flora M Hammond; Susan D Horn; Randall J Smout; Cynthia L Beaulieu; Ryan S Barrett; David K Ryser; Teri Sommerfeld Journal: Arch Phys Med Rehabil Date: 2015-08 Impact factor: 3.966