Early versus late lateral ventricular enlargement following closed head injury.

Serial computed tomographic scans in 39 closed head injury patients were measured by planimetry. The ventricle-brain ratio was computed, and the lateral ventricles were considered to be enlarged or normal based on measurements from a control group. Delayed ventricular enlargement was common after head injury producing low Glasgow Coma Scale scores and prolonged coma, whereas subarachnoid/intraventricular haemorrhage was more common with early enlargement. The degree of ventriculomegaly was related to neuropsychological test performance only when enlargement was delayed. It is postulated that diffuse axonal injury and hypoxic-ischaemic insult contributed to late ventricular enlargement, whereas a compensated obstruction of cerebrospinal fluid may be the predominant cause in the early group.