Abstract
BACKGROUND: Non-obstructive hydrocephalus sometimes occur after severe head trauma, however, the incidence or mechanism for the development of hydrocephalus is not well understood.
OBJECTIVE: We investigated the risk of hydrocephalus development.
METHODS: We retrospectively investigated the patients with head trauma, who presented severe neurological condition (Glasgow Coma Scale, GCS < 8) or underwent surgical treatments. Patients who were demonstrated the dilated ventricle on head CT scan 4 weeks after the trauma and presented disorientation, urinary incontinence, or gait disturbance are diagnosed as a hydrocephalus. For these patients, ventriculo-peritoneal shunt (VPS) was performed. We entered the patient age, sex, radiographical findings, the cause of trauma, treatment and serum fibrinogen concentration on a computerized data base.
RESULTS: Fifty-five patients were included in this study and 12 underwent VPS. The average of GCS at admission was 5.1 and 9.3 in patients with or without VPS, respectively (p<0.001). Serum fibrinogen concentration was followed in 6 and 7 patients with or without VPS. The average of serum fibrinogen concentration at 4 weeks after the trauma was 536.5 mg/dl in patients with VPS, which was higher than the upper limit of the normal range. On contrary, it was 278.7 mg/dl, which was within the normal range (p=0.002).
CONCLUSION: Low score of GCS at admission and high concentration of serum fibrinogen in chronic phase might possibly indicate the hydrocephalus development in patients with severe head trauma.
