Abstract:

Objective

To investigating the different surgical plans for patients with hydrocephalus after decompressive craniectomy of severe traumatic brain injury.

Methods

The clinical data of 89 patients with severe traumatic brain injury underwent craniotomy to bone flap decompression combined with post-traumatic hydrocephalus after trauma were retrospectively analyzed.Four groups were difined according to the different operation mode:group of early ventriculo-peritoneal shunt(VPS)+cranioplasty seventeen cases;group delay extension of ventriculo peritoneal shunt(VPS)+skull neoplasty in twenty-two cases;first VPS for cranioplasty group thirty-one cases(VPS),first skull repair surgery again VPS group nineteen cases(after VPS group).

Results

Early group,group delay,first VPS group and after VPS group treatment efficiency was 88.2%,86.4%,90.3%and 89.5%,respectively.The differences between any two groups show no statistical significance(P>0.05);and the complications of the three groups in shunt tube plugging rate had no difference(P>0.05);early group scalp infection rate was significantly higher than that of the first VPSgroup(17.6%vs 6.5%),the first VPSgroup and underwent VPSgroup postoperative subdural hematoma or effusion incidence(respectively 3.2%and 5.2%)was significantly lower than that of the early group and late stage group(11.76%and 9.09%,respectively;P<0.05).

Conclusion

Directe at post-traumatic hydrocephalus patients caused by bone flap decompression after severe traumatic brain injury,early,late and VPSgroup,after VPS group treatment options no difference,operation scheme choicebenefits to patientswho underwent.

Key words: Severe traumatic brain injury, Post-traumatic hydrocephalus, Cranioplasty, Subdural collection of fluid, Surgical options