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Category: Volume 06 Issue 08 August 2018
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Title: Assessment of Risk Factors, Features, Treatment Modalities and Prognosis of Posttraumatic Hydrocephalus: A Retrospective Hospital Based Study

Authors: Dr Uday Bhaumik, Dr Govind Mangal

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i8.18

Abstract

Background: Posttraumatic hydrocephalus (PTH) is a frequent and serious complication that follows a traumatic brain injury (TBI). Its incidence varies greatly from study to study, largely based on different criteria for its diagnosis.

Aims and Objectives: To find out risk factors, treatment modalities and prognosis of cases with Posttraumatic Hydrocephalus.

Material and Methods: This retrospective study was conducted in Department of Neurosurgery at Geetanjali Medical College and Hospital, Udaipur, Rajasthan on the basis of neuro-radiological examination of patients. A total of 500 patients were evaluated for traumatic head Injury in hospital from Jan 2014 – Dec 2017. 40 cases with diagnosis of post traumatic hydrocephalus PTH were identified.

Result: Post traumatic Hydrocephalus (PTH) was observed in 40 patients out of total 500 patients over period of time. Thus, incidence of the PTH was found to be 8.0%. Out of 40 patients, 33 (82.5%) were males and 7 (17.5%) were females. Mean age of PTH patients was 27.96 ± 12. Regarding mode of injury 36 (90.0%) out of 40 injured due to Road Traffic Accidents. Severe HI (GCS ≤ 8) was present in 31 (77.5%) cases. Findings of CT scan showed that majority 29 (72.5%) cases had predominant contusions. 30 (75.0%) cases of HI treated with DI. Out of 30 cases of DC, 23(76.67%) diagnosed with PTH before cranioplasty. Significant correlation was observed between severe HI, DC and time duration between HI and PTH diagnosis. (p = 0.039). Regarding the clinical features at PTH presentation the triad of Memory, Gait and urinary disturbance was observed in 21 (52.5%) cases followed by other features. In majority of cases VP shunt placement was done. Overall mortality was 6 out 0f 31(19.35%) with the outcome measured by GCS. Out of 25 (80.64%) cases who recovered out of 31, 17 (68.0%) had good recovery according to GCS.

Conclusion: PTH could greatly impact morbidity following a severe head injury and could result in increased mortality if it is not recognized and treated.

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Corresponding Author

Dr Uday Bhaumik

Assistant Professor, Department of Neurosurgery, Geetanjali Medical College and Hospital, Udaipur, India