Artikel
Risk factors for post-traumatic hydrocephalus following decompressive craniectomy
Risikofaktoren für posttraumatischen Hydrozephalus nach dekompressiver Kraniektomie
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Veröffentlicht: | 8. Mai 2019 |
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Gliederung
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Objective: Posttraumatic, hydrocephalus after decompressive craniectomy is underestimated sequelae of traumatic brain injury (TBI). The objective of this study is to determine possible surgery- or trauma-related risk factors of hydrocephalus and shunting after decompressive craniectomy.
Methods: We retrospectively analyzed the demographics, charts and imaging data from adult patients who underwent a decompressive craniectomy due to a TBI in our hospital between 2007–2017. Additionally, surgical factors such as timing, diameter of craniectomy, distance to midline and mean area of craniectomy were investigated, alongside with the pathoanatomical classification using the novel Stockholm and Helsinki CT Scores.
Results: In total, 210 patients underwent a decompressive craniectomy after TBI. 19 patients (9%) developed a hydrocephalus with consecutive permanent CSF shunting. Distance from the midline (25 mm; p=0.01), abundance of intraventricular blood in the CT scan (p=0.056), a high Helsinki Score (25 mm (p=0.03 OR=3 CI95% 0.2–1.5) and a high (≥6) Helsinki Score (p=0.01, OR=6 CI 95% 0.3–1.5) as independent rick factors for post-decompression hydrocephalus.
Conclusion: Our retrospective study demonstrates that surgery- and TBI-related factors play a role in the development of posttraumatic hydrocephalus after a decompressive craniectomy.