Journal of Korean Neurosurgical Society

  • 제60권6호
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  • Pages.730-737
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  • 2017
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Factors Associated Postoperative Hydrocephalus in Patients with Traumatic Acute Subdural Hemorrhage

  • Kim, Han (Department of Neurosurgery, Myongji Hospital) ;
  • Lee, Heui Seung (Department of Neurosurgery, Myongji Hospital) ;
  • Ahn, Sung Yeol (Department of Neurosurgery, Myongji Hospital) ;
  • Park, Sung Chun (Department of Neurosurgery, Myongji Hospital) ;
  • Huh, Won (Department of Neurosurgery, Myongji Hospital)
  • 투고 : 2017.07.07
  • 심사 : 2017.09.30
  • 발행 : 2017.11.01
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초록

Objective : Postoperative hydrocephalus is a common complication following craniectomy in patients with traumatic brain injury, and affects patients' long-term outcomes. This study aimed to verify the risk factors associated with the development of hydrocephalus after craniectomy in patients with acute traumatic subdural hemorrhage (tSDH). Methods : Patients with acute traumatic SDH who had received a craniectomy between December 2005 and January 2016 were retrospectively assessed by reviewing the coexistence of other types of hemorrahges, measurable variables on computed tomography (CT) scans, and the development of hydrocephalus during the follow-up period. Results : Data from a total of 63 patients who underwent unilateral craniectomy were analyzed. Postoperative hydrocephalus was identified in 34 patients (54%) via brain CT scans. Preoperative intraventricular hemorrhage (IVH) was associated with the development of hydrocephalus. Furthermore, the thickness of SDH (p=0.006) and the extent of midline shift before craniectomy (p=0.001) were significantly larger in patients with postoperative hydrocephalus. Indeed, multivariate analyses showed that the thickness of SDH (p=0.019), the extent of midline shift (p<0.001) and the coexistence of IVH (p=0.012) were significant risk factors for the development of postoperative hydrocephalus. However, the distance from the midline to the craniectomy margin was not an associated risk factor for postoperative hydrocephalus. Conclusion : In patients with acute traumatic SDH with coexisting IVH, a large amount of SDH, and a larger midline shift, close follow-up is necessary for the early prediction of postoperative hydrocephalus. Furthermore, craniectomy margin need not be limited in acute traumatic SDH patients for the reason of postoperative hydrocephalus.

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참고문헌

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피인용 문헌

  1. Predictors Associated With Post-Traumatic Hydrocephalus in Patients With Head Injury Undergoing Unilateral Decompressive Craniectomy vol.9, pp.None, 2017, https://doi.org/10.3389/fneur.2018.00337
  2. Development of Posttraumatic Hydrocephalus Requiring Ventriculoperitoneal Shunt After Decompressive Craniectomy for Traumatic Brain Injury: a Systematic Review and Meta-analysis of Retrospective Studi vol.72, pp.3, 2017, https://doi.org/10.5455/medarh.2018.72.214-219
  3. Postoperative complications influencing the long‐term outcome of head‐injured patients after decompressive craniectomy vol.9, pp.1, 2017, https://doi.org/10.1002/brb3.1179
  4. Post Traumatic Hydrocephalus: Incidence, Pathophysiology and Outcomes vol.69, pp.8, 2017, https://doi.org/10.4103/0028-3886.332264
  5. Factors associated with the development and outcome of hydrocephalus after decompressive craniectomy for traumatic brain injury vol.44, pp.1, 2017, https://doi.org/10.1007/s10143-019-01179-0