The reported incidence of post-traumatic hydrocephalus (PTH) in literature varies
from 0.7–29%. It is a treatable complication of head injury and presents with different
clinical syndromes. We manage 38 cases of post-traumatic hydrocephalus in our hospital
between January 2009 and April 2010. Clinicoradiology was studied at initial trauma,
and at presentation with symptoms suggestive of increased ICP. Post ventriculo-peritoneal
shunt outcome was analyzed. Sixty-eight percent cases were of severe head injury.
Contusions (73.6%) and SAH (50%) were the most common CT findings. Sixty-five percent
cases had been managed by decompressive craniectomy at the time of initial injury.
Deterioration in consciousness (57.8%) and hemiparesis (26.3%) were most common presenting
features of PTH, usually after 65±38 days (mean±SD) of initial injury. Patients were
managed by antibiotic impregnated ventriculo-peritoneal shunt. Shunt revision and
infection rates were 18.4% and 12.8% respectively. Thirty cases (78.9%) improved,
2 (5.2%) showed no improvement and 6 (15.7%) died. PTH is a treatable complication
of head injury with a favorable outcome and therefore should be aggressively managed
by CSF shunting.
Keywords
head injury - hydrocephalus - ventriculo-peritoneal shunting
