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Patients are at increased risk of developing hydrocephalus after sustaining traumatic brain injury

After experiencing a traumatic brain injury (TBI), individuals may experience a number of secondary complications that can interfere with the recovery process. One of these is post-traumatic hydrocephalus, a condition in which head trauma causes fluid to accumulate in the brain, potentially leading to further tissue damage and impaired brain function. Clinicians are aware of the dangers associated with post-traumatic hydrocephalus, but common symptoms of the condition—such as headaches, blurred vision, nausea, and sleep disturbances—are often mistakenly attributed solely to the TBI, allowing fluid accumulation to continue undetected. Fortunately, hydrocephalus is effectively treated by inserting a shunt to drain excess fluid from the brain. To quickly and accurately determine which patients may need a shunt to treat post-traumatic hydrocephalus, clinicians need to understand the factors that can put TBI patients at higher risk of developing the condition.

A recent Taiwanese study investigated the occurrence of post-traumatic hydrocephalus in TBI patients who also experienced a subarachnoid hemorrhage (SAH), a highly fatal type of stroke caused by bleeding into the space surrounding the brain. Using Taiwan’s Longitudinal Health Insurance Database, researchers collected medical data from 23,775 patients who were hospitalized for TBI between 2000 and 2010. They found that patients who experienced SAH were three times more likely to develop hydrocephalus within two years of their injury. Although hydrocephalus was found to occur for years following TBI, patients were most likely to develop the condition in the first three months after injury.

Because there is significant symptom overlap between hydrocephalus and TBI, clinicians are advised to screen and remain alert for evidence of hydrocephalus in TBI patients, particularly during the acute phase of recovery. Additionally, clinicians should remain aware that patients who have survived TBI-induced SAH are at significantly increased risk of hydrocephalus and may require additional monitoring to ensure that treatment is delivered as quickly as possible.

Chen KH, Lee CP, Yang YH, et al. Incidence of hydrocephalus in traumatic brain injury: A nationwide population-based cohort study. Medicine. (September 2019).

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