The volume of traumatic intraventricular hematoma does not correlate with the development of post-traumatic hydrocephalus
Sérgio Miguel Fernandes Romualdo (Dresden), Markus Dengl (Dresden), Markus G. Prem (Dresden), Ilker Y. Eyüpoglu (Dresden), Gabriele Schackert (Dresden), Tareq Juratli (Dresden), Kerim Hakan Sitoci-Ficici (Dresden)
Severe traumatic brain injury (TBI) is a devastating condition, and a post-traumatic hydrocephalus (PTH) worsens the outcome further. Previous studies have explored the impact of intraventricular hemorrhage (IVH) on the development of PTH. Our group previously investigated whether the prevalence of IVH in TBI patients has any effect on development of a PTH but found no statistical significance. In this study, we hypothesized that the volume of IVH might indeed influence the likelihood of developing PTH.
We utilized the existing patient database of our department, which includes all patients who underwent decompressive craniectomy (DC) for traumatic brain injury (TBI) from 2008 to 2019 and had complete data sets. We focused on the subgroup with IVH, evident in either initial or follow-up cranial CT scans. IVH volumes were calculated via manual segmentation using BrainLab® software, with the highest recorded values analysed. Patients were categorized into two groups: those who did not develop PTH requiring shunt implantation (Non-Shunt group) and those who did (Shunt group).
The study comprised 126 patients (93 males, 33 females) with a median age of 53 years (range: 18-84 years). The Shunt group included 34 patients (27%). Of all patients, 28 (22.2%) exhibited IVH. The Non-Shunt group had a median IVH volume of 1.65 cm³, an average of 5.05 cm³, and an interquartile range (IQR) of 2.54 cm³. In the Shunt group, these values were a median of 1.46 cm³, an average of 9.05 cm³, and an IQR of 13.62 cm³. The Mann-Whitney U test yielded a non-significant p-value of 0.817. Further analysis using a 6 cm³ volume cut-off and the Fisher exact test also showed a non-significant p-value of 0.269.
Our study found no significant correlation between IVH volume and the development of PTH in patients undergoing DC following TBI. These findings suggest that the presence, independent of its volume, alone may not be a reliable predictor for the development of PTH in this patient population.