Risk Factors Associated With The Occurrence Of Hydrocephalus Following Decompressive Craniectomy In Traumatic Brain-injured Patients

Objective:We conducted a retrospective review of 102 consecutive patients of traumatic brain-injured(TBI)who were treated with decompressive craniectomy(DC),and our aims to identify risk factors for developing postoperative hydrocephalus after the surgical procedure.Methods:This study included 102 patients who underwent DC for TBI with minimum follow-up of 6 months from 2015 to 2020 in a single center,and the clinical and radiology data were retrospectively analyzed.All cases were divided into two groups according to Evans index(EI): hydrocephalus group(15 cases)and non-hydrocephalus group(87 cases),a univariate analysis was performed by comparison of two groups and we used multivariate logistic regression models to identify the potential risks for hydrocephalus following DC in patients with TBI.Results:The incidence of hydrocephalus after DC in patients with TBI was 14.71% in this study.The result of logistic regression analysis revealed that the significant risk factors causing hydrocephalus after DC included intraventricular hemorrhage(OR=7.315(2.007,26.685),P=0.001),interhemispheric subdural hygroma(OR=5.412(1.437,19.887),P=0.003)and craniectomy margin from mid-line < 25mm(OR=6.176(1.934,19.722),P=0.002).Conclusion:Our results show that traumatic brain-injured patients with intraventricular hemorrhage,interhemispheric subdural hygroma,or of whom the length from the upper margin of craniectomy to the midline is less than 25 mm are more likely to suffer from hydrocephalus after decompressive craniectomy.