Hydrocephalus associated with childhood nonaccidental head trauma.
Publication/Presentation Date
11-1-2016
Abstract
OBJECTIVE The incidence of posttraumatic ventriculomegaly (PTV) and shunt-dependent hydrocephalus after nonaccidental head trauma (NAHT) is unknown. In the present study, the authors assessed the timing of PTV development, the relationship between PTV and decompressive craniectomy (DC), and whether PTV necessitated placement of a permanent shunt. Also, NAHT/PTV cases were categorized into a temporal profile of delay in admission and evaluated for association with outcomes at discharge. METHODS The authors retrospectively reviewed the cases of patients diagnosed with NAHT throughout a 10-year period. Cases in which sequential CT scans had been obtained (n = 28) were evaluated for Evans' index to determine the earliest time ventricular dilation was observed. Discharge outcomes were assessed using the King's Outcome Scale for Childhood Head Injury score. RESULTS Thirty-nine percent (11 of 28) of the patients developed PTV. A low admission Glasgow Coma Scale (GCS) score predicted early PTV presentation (within < 3 days) versus a high GCS score (> 1 week). A majority of PTV/NAHT patients presented with a subdural hematoma (both convexity and interhemispheric) and ischemic stroke, but subarachnoid hemorrhage was significantly associated with PTV/NAHT (p = 0.011). Of 6 patients undergoing a DC for intractable intracranial pressure, 4 (67%) developed PTV (p = 0.0366). These patients tended to present with lower GCS scores and develop ventriculomegaly early. Only 2 patients developed hydrocephalus requiring shunt placement. CONCLUSIONS PTV presents early after NAHT, particularly after a DC has been performed. However, the authors found that only a few PTV/NAHT patients developed shunt-dependent hydrocephalus.
Volume
41
Issue
5
First Page
E8
ISSN
1092-0684
Published In/Presented At
Vadivelu, S., Rekate, H. L., Esernio-Jenssen, D., Mittler, M. A., & Schneider, S. J. (2016). Hydrocephalus associated with childhood nonaccidental head trauma. Neurosurgical Focus, 41(5), E8. Retrieved from https://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=27798981&site=ehost-live&scope=site&authtype=uid&user=lvhnlibrary1&password=Library1
Disciplines
Medicine and Health Sciences | Pediatrics
PubMedID
27798981
Department(s)
Department of Pediatrics, Department of Pediatrics Faculty
Document Type
Article