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Abstract

Objective: To explore the risk factors of post-traumatic hydrocephalus (PTH) in patients with traumatic brain injury (TBI) decompressive craniectomy (DC).
Methodology: This was a retrospective study. The objects of study were 92 TBI patients who met the eligibility criteria for routine DC treatment in the Department of Neurosurgery of Liaocheng People’s Hospital from January 2022 to December 2023. Furthermore, risk factors of PTH were determined by univariate and multivariate Logistic regression analysis.
Results: According to the results of univariate analysis, there was correlation of PTH formation with DC grading, midline shift, operation time, intraoperative blood loss, tracheotomy, subdural hygroma, interhemispheric hygroma, ventricular dilatation, postoperative large-area cerebral ischemia and infarction. Furthermore, multivariate Logistics regression analysis revealed that the occurrence of subdural hygroma (OR 3.392 [95% CI 1.259-9.137]; p=0.016) was an independent prognostic factor of PTH. In addition, compared with non-operation group (conservative group, n=12) with lumbar puncture and/or lumbar cistern drainage and/or lateral external ventricular drain (LEVD), the curative effect was significantly better in the operation group with cranioplasty (CP) and/or ventriculo-peritoneal shunt (VPS) (p=0.029).
Conclusion: The occurrence of subdural hygroma is an independent risk factor for hydrocephalus formation. For the cases of PTH combined with TBI, it is recommended to carry out individualized precision treatment according to the specific situation to control the malignant progression of hydrocephalus.