Overview
Post-traumatic non-communicating hydrocephalus is a condition characterized by the abnormal accumulation of cerebrospinal fluid (CSF) within the cranial cavity following a traumatic brain injury (TBI), leading to increased intracranial pressure (ICP) 1. This occurs when the normal flow of CSF is obstructed, preventing its reabsorption 1.Diagnosis
Diagnosis is typically made based on clinical signs of increased ICP and confirmed with neuroimaging 1.
Neuroimaging modalities such as CT or MRI are used to identify ventricular enlargement and CSF flow obstruction 1.Management
Management focuses on reducing intracranial hypertension 1.
Intracranial pressure (ICP) monitoring is a key component of management in severe TBI 1.
Decompressive craniectomy (DC) is a surgical option considered for managing refractory intracranial hypertension 1.Key Recommendations
ICP monitoring should be utilized in the management of intracranial hypertension following severe TBI 1. (Evidence: Expert opinion)
Decompressive craniectomy is a treatment option for patients with severe TBI experiencing intracranial hypertension 1. (Evidence: Expert opinion)
There is a lack of robust evidence from prospective randomized controlled trials regarding the management of intracranial hypertension following severe TBI, necessitating reliance on expert consensus and best practice proposals 1. (Evidence: Expert opinion)References
1 Iaccarino C, Lippa L, Munari M, Castioni CA, Robba C, Caricato A et al.. Management of intracranial hypertension following traumatic brain injury: a best clinical practice adoption proposal for intracranial pressure monitoring and decompressive craniectomy. Joint statements by the Traumatic Brain Injury Section of the Italian Society of Neurosurgery (SINch) and the Neuroanesthesia and Neurocritical Care Study Group of the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI). Journal of neurosurgical sciences 2021. link