Clinical Analysis of Hydrocephalus Patients Who Underwent Shunt Surgery after Traumatic Brain Injury

Min Ki Kim; Bong Jin Park; Hee Sup Shin; Seok Keun Choi; Sung Bum Kim; Tae Sung Kim; Bong Arm Rhee; Young Jin Lim

doi:10.13004/jknts.2011.7.2.88

Journal List > J Korean Neurotraumatol Soc > v.7(2) > 1084106

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Kim, Park, Shin, Choi, Kim, Kim, Rhee, and Lim: Clinical Analysis of Hydrocephalus Patients Who Underwent Shunt Surgery after Traumatic Brain Injury

Clinical Article

Journal of Korean Neurotraumatology Society 2011; 7(2): 88-91.

Published online: 31 October 2011

DOI: https://doi.org/10.13004/jknts.2011.7.2.88

Clinical Analysis of Hydrocephalus Patients Who Underwent Shunt Surgery after Traumatic Brain Injury

Min Ki Kim, MD, Bong Jin Park, MD, Hee Sup Shin, MD, Seok Keun Choi, MD, Sung Bum Kim, MD, Tae Sung Kim, MD, Bong Arm Rhee, MD, Young Jin Lim, MD

Department of Neurosurgery, Kyung Hee University Hospital, Seoul, Korea.

Address for correspondence: Bong Jin Park, MD. Department of Neurosurgery, Kyung Hee University Hospital, 1 Hoegi-dong, Dongdaemun-gu, Seoul 130-702, Korea. Tel: +82-2-958-8385, Fax: +82-2-958-8380, nsorvos@gmail.com

Received 19 August 2011 Revised 15 September 2011 Accepted 15 September 2011

Abstract

Objective

Ventricular enlargement and hydrocephalus after traumatic brain injury (TBI) are relatively common findings. However, selecting patients for shunt surgery is difficult to determine and clinical outcomes after shunt surgery also varies. In this clinical study, we analyzed clinical features and outcomes of hydrocephalus patients who have undergone shunt surgery after traumatic brain injury.

Methods

Total of 162 patients underwent shunt surgery between January, 2006 and December, 2010. Among these patients, we reviewed patients' medical records retrospectively and found neuroradiological findings of 17 patients with TBI. We divided patients into two groups: poor response to shunt surgery and good response to shunt surgery. Within each group, we analyzed clinical diagnosis, operation methods to traumatic brain injury, Glasgow coma scale (GCS), computed tomography (CT) scans, radionuclide cisternography and finally the interval between TBI and shunt surgery.

Results

Number of patients divided into each group were 8 and 9, respectively. GCS on traumatic onset of each group were 5.5 and 9.8. And the differences of each group were statistically significant (p=0.020). GCS before shunt surgery were 8.5 and 11.1 respectively. There were no significant differences in age, diagnosis, and interval between TBI and shunt surgery.

Conclusion

Hydrocephalus after TBI is considered to be related with decreased absorption of cerebrospinal fluid. In selecting patients for shunt surgery, thorough analysis of clinical manifestation (GCS score) and neuroradiological images (radionuclide cisternography) should be considered.

Keywords: Traumatic brain injury, Hydrocephalus, Shunt

Figures and Tables

TABLE 1

Demographic characteristics

Data are mean±standard deviation or number of patients. TBI: traumatic brain injury, SDH: subdural hemorrhage, SAH: subarachnoid hemorrhage, EDH: epidural hemorrhage, Hrr: hemorrhage

TABLE 2

Summary of response to shunt surgery

Data are mean±standard deviation or number of patients. GCS: Glasgow Coma Scale, GOS: Glasgow Outcome Scale, LP: lumbar puncture

TABLE 3

Outcome of shunt surgery of PTH

Date are number of patients. GR: good response, PTH: post-traumatic hydrocephalus

Notes

The authors have no financial conflicts of interest.

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