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Clinical features associated with the development of hydrocephalus following TBI in the paediatric age group

INTRODUCTION: Predictive factors for post-traumatic hydrocephalus (PTH) in adults have been elucidated but remain uncertain for children. We aimed to identify the prevalence of PTH in paediatric patients and identify clinical/radiological factors which may increase the probability of children develo...

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Autores principales: Ved, Ronak, Fraser, Rebecca, Hamadneh, Sarah, Zaben, Malik, Leach, Paul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7835188/
https://www.ncbi.nlm.nih.gov/pubmed/32601900
http://dx.doi.org/10.1007/s00381-020-04764-7
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author Ved, Ronak
Fraser, Rebecca
Hamadneh, Sarah
Zaben, Malik
Leach, Paul
author_facet Ved, Ronak
Fraser, Rebecca
Hamadneh, Sarah
Zaben, Malik
Leach, Paul
author_sort Ved, Ronak
collection PubMed
description INTRODUCTION: Predictive factors for post-traumatic hydrocephalus (PTH) in adults have been elucidated but remain uncertain for children. We aimed to identify the prevalence of PTH in paediatric patients and identify clinical/radiological factors which may increase the probability of children developing PTH. METHODS: This was a retrospective study of all patients < 16 years old admitted to our unit with traumatic brain injury (TBI) between March 2013 and June 2018, 108 patients in total. Patients were classified as mild (13–15), moderate (9–12) or severe (3–8) TBI based on admission GCS. Three independent reviewers collected data from case notes. CT scans were reviewed for hydrocephalus using Evan’s index. Two-tailed Fisher’s exact tests with a p value < 0.05 were considered statistically significant. RESULTS: Median patient age was 7 years, and 65% were males (n = 70). PTH wasn’t identified in any patients with mild/moderate TBI (n = 79). In cases of severe TBI (n = 29), three patients developed PTH requiring ventriculoperitoneal shunting (10%; p = 0.02). Radiological features which were significantly more common in the PTH group were intraventricular haemorrhage (p = 0.05) and subarachnoid haemorrhage (p = 0.03). There was also a trend towards a statistically significant association with subdural haematoma (p = 0.07). The need for other neurosurgical procedures, such as fracture elevation and craniotomy, did not increase the probability of developing with PTH (p = 0.08). DISCUSSION: The prevalence of PTH in our study is 2.7%. Factors which may be associated with a higher probability of developing PTH may include IVH, SAH, severity of TBI, and subdural haematoma. We propose a national prospective multicentre database of paediatric PTH. The data collected on prevalence, presentation, risk factors, and management could guide contemporary management and improve the outcomes of children with PTH.
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spelling pubmed-78351882021-01-29 Clinical features associated with the development of hydrocephalus following TBI in the paediatric age group Ved, Ronak Fraser, Rebecca Hamadneh, Sarah Zaben, Malik Leach, Paul Childs Nerv Syst Original Article INTRODUCTION: Predictive factors for post-traumatic hydrocephalus (PTH) in adults have been elucidated but remain uncertain for children. We aimed to identify the prevalence of PTH in paediatric patients and identify clinical/radiological factors which may increase the probability of children developing PTH. METHODS: This was a retrospective study of all patients < 16 years old admitted to our unit with traumatic brain injury (TBI) between March 2013 and June 2018, 108 patients in total. Patients were classified as mild (13–15), moderate (9–12) or severe (3–8) TBI based on admission GCS. Three independent reviewers collected data from case notes. CT scans were reviewed for hydrocephalus using Evan’s index. Two-tailed Fisher’s exact tests with a p value < 0.05 were considered statistically significant. RESULTS: Median patient age was 7 years, and 65% were males (n = 70). PTH wasn’t identified in any patients with mild/moderate TBI (n = 79). In cases of severe TBI (n = 29), three patients developed PTH requiring ventriculoperitoneal shunting (10%; p = 0.02). Radiological features which were significantly more common in the PTH group were intraventricular haemorrhage (p = 0.05) and subarachnoid haemorrhage (p = 0.03). There was also a trend towards a statistically significant association with subdural haematoma (p = 0.07). The need for other neurosurgical procedures, such as fracture elevation and craniotomy, did not increase the probability of developing with PTH (p = 0.08). DISCUSSION: The prevalence of PTH in our study is 2.7%. Factors which may be associated with a higher probability of developing PTH may include IVH, SAH, severity of TBI, and subdural haematoma. We propose a national prospective multicentre database of paediatric PTH. The data collected on prevalence, presentation, risk factors, and management could guide contemporary management and improve the outcomes of children with PTH. Springer Berlin Heidelberg 2020-06-29 2021 /pmc/articles/PMC7835188/ /pubmed/32601900 http://dx.doi.org/10.1007/s00381-020-04764-7 Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Original Article
Ved, Ronak
Fraser, Rebecca
Hamadneh, Sarah
Zaben, Malik
Leach, Paul
Clinical features associated with the development of hydrocephalus following TBI in the paediatric age group
title Clinical features associated with the development of hydrocephalus following TBI in the paediatric age group
title_full Clinical features associated with the development of hydrocephalus following TBI in the paediatric age group
title_fullStr Clinical features associated with the development of hydrocephalus following TBI in the paediatric age group
title_full_unstemmed Clinical features associated with the development of hydrocephalus following TBI in the paediatric age group
title_short Clinical features associated with the development of hydrocephalus following TBI in the paediatric age group
title_sort clinical features associated with the development of hydrocephalus following tbi in the paediatric age group
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7835188/
https://www.ncbi.nlm.nih.gov/pubmed/32601900
http://dx.doi.org/10.1007/s00381-020-04764-7
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