Neurologic improvement following shunt placement for post-traumatic hydrocephalus in a child.

Post-traumatic hydrocephalus (PTH) is a medical complication of traumatic brain injury (TBI). There have been numerous reports of functional gains after shunt placement for PTH in adults but only rare observations about children. In this report, we present a child with PTH who displayed dramatic neurologic improvement after shunting. A 7-year-old boy sustained a severe TBI in a motor vehicle accident. When admitted for rehabilitation, his eyes were spontaneously open and he withdrew all extremities to pain but failed to follow commands. In rehabilitation, he made slow, steady progress in his cognitive and physical abilities. A CT scan conducted two months post-injury revealed marked ventriculomegaly necessitating shunt placement. Post-surgery, he began to verbalize, and was oriented to personal information. This case suggests that in children as well as adults with severe TBI and limited cognitive recovery, the possibility of PTH should be considered.