Article

The objective of this study was to determine the incidence of posttraumatic
hydrocephalus (PTH) among patients in our rehabilitation unit for traumatic brain
injury. Furthermore, we aimed to assess the effect of shunt implantation and to
identify the postoperative complication rate. This is a retrospective cohort
study, in which between 2000 and 2009, data were collected from inpatients with
traumatic brain injury complicated by PTH. During this period, 55 patients in our
unit presented with PTH; all of these patients underwent ventricular shunt
implantation. The incidence of PTH treated with shunt implantation was 4.8%. The
mean age of the patients was 32 years (range 14-75 years). In 22 cases, the
hydrocephalus was diagnosed in our rehabilitation unit (40%). Other patients were
diagnosed and shunted before being transferred to our department. The median time
of shunting was 80 days (range 20-270 days) after brain trauma. On the basis of
scores of the functional independence measure, improvement could be observed in
43 cases (78%), the mean score improvement was 40 (2-81). Postoperative
complications were seen in 10 patients (18%): four due to infections and six due
to shunt failure. Revision was necessary in all 10 cases. Almost half of the
diagnoses of PTH were established in the postacute rehabilitation unit, and all
complications after shunt implantation were also recognized there. Precise
clinical observation is necessary for diagnosis of PTH. Early diagnosis and
treatment are important to prevent secondary complications. Teamwork and good
cooperation between acute and postacute care are necessary for successful
rehabilitation of patients with traumatic brain injury.

Langue : ANGLAIS