Cerebrospinal fluid dynamics in non-acute post-traumatic ventriculomegaly

Lalou, Afroditi D; Levrini, Virginia; Czosnyka, Marek; Gergelé, Laurent; Garnett, Matthew; Kolias, Angelos G.; Hutchinson, Peter J.; Czosnyka, Zofia

doi:10.1186/s12987-020-00184-6

Cited by 25 publications

(38 citation statements)

References 57 publications

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“…In their paper, the authors retrospectively analyzed the infusion tests performed on 36 patients with post-traumatic ventriculomegaly [9]. They calculated the resistance to CSF outflow (Rout), AMP (pulse amplitude of intracranial pressure, ICP), dAMP (AMPplateau-AMPbaseline).…”

Section: Methods and Resultsmentioning

confidence: 99%

“…Lalou et al [9] incorrectly wrote that 'To best knowledge, other infusion test parameters besides ICP and Rout have not been studied in PTH … The fact that there is no high-grade evidence for using infusion tests for patients with PTH was one reason for us to study the subject, since no one has attempted to build the evidence since Marmarou'.…”

Section: Discussionmentioning

confidence: 99%

“…only selected patients using radiological criteria and all patients underwent CSF shunt. In Lalou series [9], instead, selection of patients for surgery varied and included several nonstandardized factors. This cannot allow a precise estimate of positive and negative predictive values of infusion test parameters.…”

Section: Discussionmentioning

confidence: 99%

“…Curiously, Lalou et al [9] included patients whose time interval between the TBI and infusion varied from 10 days to 33.5 years. How can post-traumatic hydrocephalus develop or be cured 33 years after trauma remains unclear.…”

Section: Discussionmentioning

confidence: 99%

“…In this context, the Cambridge group has recently published a very interesting paper on CSF dynamics analysis of patients with post-traumatic ventriculomegaly [9]. The choice of the term ventriculomegaly in the title reflects the difficulty in differentiating a ventricular enlargement (secondary to post-traumatic brain damage with atrophy) from an active, hydrocephalic process.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Post-traumatic hydrocephalus: the Cinderella of Neurotrauma

Bonis

Anile

2020

Expert Review of Neurotherapeutics

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Section: Methods and Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Post-traumatic hydrocephalus: the Cinderella of Neurotrauma

Bonis

Anile

2020

Expert Review of Neurotherapeutics

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Posttraumatic hydrocephalus: Recent advances and new therapeutic strategies

Sanker,

Kundu,

El Kassem

et al. 2023

Health Science Reports

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BackgroundHydrocephalus or ventriculomegaly is a condition brought on by an overabundance of cerebrospinal fluid (CSF) in the ventricular system. The major contributor to posttraumatic hydrocephalus (PTH) is traumatic brain injuries (TBIs), especially in individuals with occupations set in industrial settings. A variety of criteria have been employed for the diagnosis of PTH, including the combination of neurological symptoms like nerve deficits and headache, as well as an initial improvement followed by a worsened relapse of altered consciousness and neurological deterioration, which is detected by computed tomography‐brain imaging that reveals gradual ventriculomegaly.AimIn this article, we discuss and summarize briefly the current understandings and advancements in the management of PTH.MethodsThe available literature for this review was searched on various bibliographic databases using an individually verified, prespecified approach. The level of evidence of the included studies was considered as per the Centre for Evidence‐Based Medicine recommendations.ResultsThe commonly practiced current treatment modality involves shunting CSF but is often associated with complications and recurrence. The lack of a definitive management strategy for PTH warrants the utilization of novel and innovative modalities such as stem cell transplantations and antioxidative stress therapies.ConclusionOne of the worst complications of a TBI is PTH, which has a high morbidity and mortality rate. Even though there hasn't been a successful method in stopping PTH from happening, hemorrhage‐derived blood, and its metabolic by‐products, like iron, hemoglobin, free radicals, thrombin, and red blood cells, may be potential targets for PTH hindrance and management. Also, using stem cell transplantations in animal models and antioxidative stress therapies in future studies can lower PTH occurrence and improve its outcome. Moreover, the integration of clinical trials and theoretical knowledge should be encouraged in future research projects to establish effective and updated management guidelines for PTH.

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Incidence of surgically treated post-traumatic hydrocephalus 6 months following head injury in patients undergoing acute head computed tomography

et al. 2022

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Background Post-traumatic hydrocephalus (PTH) is a well-known complication of head injury. The percentage of patients experiencing PTH in trauma cohorts (0.7–51.4%) varies greatly in the prior literature depending on the study population and applied diagnostic criteria. The objective was to determine the incidence of surgically treated PTH in a consecutive series of patients undergoing acute head computed tomography (CT) following injury. Methods All patients (N = 2908) with head injuries who underwent head CT and were treated at the Tampere University Hospital’s Emergency Department (August 2010–July 2012) were retrospectively evaluated from patient medical records. This study focused on adults (18 years or older) who were residents of the Pirkanmaa region at the time of injury and were clinically evaluated and scanned with head CT at the Tampere University Hospital’s emergency department within 48 h after injury (n = 1941). A thorough review of records for neurological signs and symptoms of hydrocephalus was conducted for all patients having a radiological suspicion of hydrocephalus. The diagnosis of PTH was based on clinical and radiological signs of the condition within 6 months following injury. The main outcome was surgical treatment for PTH. Clinical evidence of shunt responsiveness was required to confirm the diagnosis of PTH. Results The incidence of surgically treated PTH was 0.15% (n = 3). Incidence was 0.08% among patients with mild traumatic brain injury (TBI) and 1.1% among those with moderate to severe TBI. All the patients who developed PTH underwent neurosurgery during the initial hospitalization due to the head injury. The incidence of PTH among patients who underwent neurosurgery for acute traumatic intracranial lesions was 2.7%. Conclusion The overall incidence of surgically treated PTH was extremely low (0.15%) in our cohort. Analyses of risk factors and the evaluation of temporal profiles could not be undertaken due to the extremely small number of cases.

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Cerebrospinal fluid dynamics in non-acute post-traumatic ventriculomegaly

Cited by 25 publications

References 57 publications

Post-traumatic hydrocephalus: the Cinderella of Neurotrauma

Post-traumatic hydrocephalus: the Cinderella of Neurotrauma

Posttraumatic hydrocephalus: Recent advances and new therapeutic strategies

Incidence of surgically treated post-traumatic hydrocephalus 6 months following head injury in patients undergoing acute head computed tomography

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