Risk Factors For Post-traumatic Hydrocephalus Followingtraumatic Brain Injury: Amultivariate Study

Objectives To investigate the clinical risk factors of post-traumatichydrocephalus (PTH) following moderate or severe traumatic brain injuryand the effect of skull defect after decompressive craniectomy on PTH.Methods We performed a retrospective study of patients withmoderate or severe TBI in our hospital. From January2012to December2012,183patients were included in the study. Study outcomes focused onthe development of PTH within12months. Several factors were collectedsuch as gender, age, TBI types, admission Glasgow Coma Scale (GCS)score, intraventricular hemorrhage (IVH), subarachnoid hemorrhage(SAH), brain damage types, midline shift, subdural hygroma (SDH),therapeutic strategies, skull defects and so on. Univariate analyze andlogistic regression were used to analyzed these factors. The associationbetween the superior and inferior bounds of the skull defect and thedevelopment of PTH were also analyzed. Outcomes Logistic regression shows SAH （OR=6.169）,interhemispheric SDH（OR=31.743）, unilateral（OR=17.602）and bilateral（OR=30.567）skull defects were significant clinical risk factors forhydrocephalus. Of the patients with unilateral skull defects followingdecompressive craniectomy, the inferior limit≤10mm from the zygomaticarch was statistically significantly associated with the development of PTH(OR=5.500, P=0.038<0.05).Conclusion SAH, interhemispheric SDH and skull defects areclinical risk factors of PTH. Unilateral skull defects with a inferior limittoo close to the zygomatic arch (≤10mm) can predispose to thedevelopment of PTH.