To analyze and summarize the high risk factors of hydrocephalus after surgery of traumatic brain injury (TBI) and therapeutic experiences, and to provide theoretical basis for the prevention of postoperative hydrocephalus.

To enroll 126 cases of TBI patients with standard decompressive craniectomy and follow up at least with 6 months about the complication rate of hydrocephalus. The related clinical characteristics were compared and the therapeutic results were observed after ventriculo-peritoneal shunt (VPS).

Age, time of coma, lower GCS and high APACHEⅡscore when admission, location of hematoma, subarachnoid hemorrhage, intraventricular hemorrhage, lumbar puncture, intra-operative dura suture and midline shift more than 10 mm were the high risk factors of hydrocephalus after standard decompressive craniectomy of TBI patients. There were significant differences in these factors between hydrocephalus group and control group. After VPS was applied to treat the hydrocephalus patients, the patients recovered well in 30 d with normal temperature and without language dysfunction.

The high risk factors should be evaluated before the surgery of patients with TBI to prevent the complication of hydrocephalus. If there were, VPS is a suitable choice for the treatment.