Prevalence of hydrocephalus in the patients with traumatic brain injury: A systematic review and meta-analysis
DOI:
https://doi.org/10.22122/cdj.v10i2.728Keywords:
Traumatic Brain Injury, Hydrocephalus, Decompressive Craniectomy, Meta-Analysis, Prevalence, Severe Head InjuryAbstract
BACKGROUND: The purpose of this study was determination of the prevalence of post-traumatic hydrocephalus (PTH) in patients who had traumatic brain injury (TBI) worldwide.
METHODS: Four electronic databases including Scopus, PubMed, Embase, and Web of Science were searched in this meta-analysis. The random-effects model was applied for the pooled effect size of I2 > 50%. Subgroup analysis was done to evaluate the heterogeneity, and the Egger’s test was used to test the asymmetry of the funnel plots in order to assess the publication bias.
RESULTS: A total of 48 studies with 11624 patients were evaluated. The pooled prevalence of PTH was 13% [95% confidence interval (CI): 11.0-15.0] and according to decompressive craniectomy (DC) surgery was 22.0% (95% CI: 18.0-26.0). This result among patients with severe TBI (sTBI) was 16.0% (95% CI: 13.0-19.0) and it was higher in the developed countries. The prevalence of PTH was generally higher in studies with a sample size lower than 100 (21.0%) and was generally lower in studies conducted between 1990 to1999 (4.0%). These results were not too different according to the study design.
CONCLUSION: It is recommended to design a prospective clinical study in order to explain the true dynamics and circulation of the cerebrospinal fluid (CSF) after DC. Moreover, there is a need to evaluate the cost-effectiveness of DC in reducing the intracranial pressure in comparison with other available options. In fact, performing the clinical studies with higher quality in less developed countries could provide more reliable related results to achieve a true global conclusion.
References
Peeters W, van den Brande R, Polinder S, Brazinova A, Steyerberg EW, Lingsma HF, et al. Epidemiology of traumatic brain injury in Europe. Acta Neurochir (Wien). 2015; 157(10): 1683-96.
Maas AI, Stocchetti N, Bullock R. Moderate and severe traumatic brain injury in adults. Lancet Neurol. 2008; 7(8): 728-41.
Finfer SR, Cohen J. Severe traumatic brain injury. Resuscitation. 2001; 48(1): 77-90.
Marshall LF, Gautille T, Klauber MR, Eisenberg HM, Jane JA, Luerssen TG, et al. The outcome of severe closed head injury. J Neurosurg. 1991; 75(Suppl): S28-S36.
Sun S, Zhou H, Ding ZZ, Shi H. Risk factors associated with the outcome of post-traumatic hydrocephalus. Scand J Surg. 2019; 108(3): 265-70.
Ding J, Guo Y, Tian H. The influence of decompressive craniectomy on the development of hydrocephalus: a review. Arq Neuropsiquiatr. 2014; 72(9): 715-20.
Guyot LL, Michael DB. Post-traumatic hydrocephalus. Neurol Res. 2000; 22(1): 25-8.
Mazzini L, Campini R, Angelino E, Rognone F, Pastore I, Oliveri G. Posttraumatic hydrocephalus: A clinical, neuroradiologic, and neuropsychologic assessment of long-term outcome. Arch Phys Med Rehabil. 2003; 84(11): 1637-41.
Groswasser Z, Cohen M, Reider-Groswasser I, Stern MJ. Incidence, CT findings and rehabilitation outcome of patients with communicative hydrocephalus following severe head injury. Brain Inj. 1988; 2(4): 267-72.
Beyerl B, Black PM. Posttraumatic hydrocephalus. Neurosurgery. 1984; 15(2): 257-61.
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg. 2010; 8(5): 336-41.
Hoy D, Brooks P, Woolf A, Blyth F, March L, Bain C, et al. Assessing risk of bias in prevalence studies: modification of an existing tool and evidence of interrater agreement. J Clin Epidemiol. 2012; 65(9): 934-9.
Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003; 327(7414): 557-60.
Beauchamp KM, Kashuk J, Moore EE, Bolles G, Rabb C, Seinfeld J, et al. Cranioplasty after postinjury decompressive craniectomy: Is timing of the essence? J Trauma. 2010; 69(2): 270-4.
De Bonis P, Sturiale CL, Anile C, Gaudino S, Mangiola A, Martucci M, et al. Decompressive craniectomy, interhemispheric hygroma and hydrocephalus: A timeline of events? Clin Neurol Neurosurg. 2013; 115(8): 1308-12.
Chen H, Yuan F, Chen SW, Guo Y, Wang G, Deng ZF, et al. Predicting posttraumatic hydrocephalus: Derivation and validation of a risk scoring system based on clinical characteristics. Metab Brain Dis. 2017; 32(5): 1427-35.
Chen L, Bao Y, Liang Y, Wang Y, Jiang J. Surgical management and outcomes of non-missile open head injury: Report of 44 cases from a single trauma centre. Brain Inj. 2016; 30(3): 318-23.
d'Avella D, Servadei F, Scerrati M, Tomei G, Brambilla G, Massaro F, et al. Traumatic acute subdural haematomas of the posterior fossa: clinicoradiological analysis of 24 patients. Acta Neurochir (Wien). 2003; 145(12): 1037-44.
De Bonis P, Pompucci A, Mangiola A, Rigante L, Anile C. Post-traumatic hydrocephalus after decompressive craniectomy: An underestimated risk factor. J Neurotrauma. 2010; 27(11): 1965-70.
Demircivi F, Ozkan N, Buyukkececi S, Yurt I, Miniksar F, Tektas S. Traumatic subarachnoid haemorrhage: Analysis of 89 cases. Acta Neurochir (Wien). 1993; 122(1-2): 45-8.
Di G, Hu Q, Liu D, Jiang X, Chen J, Liu H. Risk factors predicting posttraumatic hydrocephalus after decompressive craniectomy in traumatic brain injury. World Neurosurg. 2018; 116: e406-e413.
Cardoso ER, Galbraith S. Posttraumatic hydrocephalus--a retrospective review. Surg Neurol. 1985; 23(3): 261-4.
Faleiro RM, Faleiro LC, Caetano E, Gomide I, Pita C, Coelho G, et al. Decompressive craniotomy: Prognostic factors and complications in 89 patients. Arq Neuropsiquiatr. 2008; 66(2B): 369-73.
Fotakopoulos G, Tsianaka E, Siasios G, Vagkopoulos K, Fountas K. Posttraumatic hydrocephalus after decompressive craniectomy in 126 patients with severe traumatic brain injury. J Neurol Surg A Cent Eur Neurosurg. 2016; 77(2): 88-92.
Ganesh S, Guernon A, Chalcraft L, Harton B, Smith B, Louise-Bender PT. Medical comorbidities in disorders of consciousness patients and their association with functional outcomes. Arch Phys Med Rehabil. 2013; 94(10): 1899-907.
Honeybul S. Complications of decompressive craniectomy for head injury. J Clin Neurosci. 2010; 17(4): 430-5.
Honeybul S, Ho KM. Long-term complications of decompressive craniectomy for head injury. J Neurotrauma. 2011; 28(6): 929-35.
Honeybul S, Ho KM. Decompressive craniectomy for severe traumatic brain injury: the relationship between surgical complications and the prediction of an unfavourable outcome. Injury. 2014; 45(9): 1332-9.
Jovanovic M, Vujotic L, Janosevic V, Soldatovic I, Radulovic D, Bogosavljevic V. Modified "in-window" technique for decompressive craniotomy for severe brain injury. Arch Biol Sci. 2015; 67(1): 275-81.
Kaen A, Jimenez-Roldan L, Alday R, Gomez PA, Lagares A, Alen JF, et al. Interhemispheric hygroma after decompressive craniectomy: does it predict posttraumatic hydrocephalus? J Neurosurg. 2010; 113(6): 1287-93.
Kan P, Amini A, Hansen K, White GL, Brockmeyer DL, Walker ML, et al. Outcomes after decompressive craniectomy for severe traumatic brain injury in children. J Neurosurg. 2006; 105(5 Suppl): 337-42.
Khan Z, Sharafat S, Ali M, Aman R, Khan KM, Alam I, et al. Bomb blast head injuries: A two years' experience of 154 patients. Rawal Medical Journal. 2012; 37(4): 417-20.
Ki HJ, Lee HJ, Lee HJ, Yi JS, Yang JH, Lee IW. The risk factors for hydrocephalus and subdural hygroma after decompressive craniectomy in head injured patients. J Korean Neurosurg Soc. 2015; 58(3): 254-61.
Kim H, Lee HS, Ahn SY, Park SC, Huh W. Factors associated postoperative hydrocephalus in patients with traumatic acute subdural hemorrhage. J Korean Neurosurg Soc. 2017; 60(6): 730-7.
Kishore PR, Lipper MH, Miller JD, Girevendulis AK, Becker DP, Vines FS. Post-traumatic hydrocephalus in patients with severe head injury. Neuroradiology. 1978; 16: 261-5.
Low CY, Low YY, Lee KK, Chan SP, Ang BT. Post-traumatic hydrocephalus after ventricular shunt placement in a Singaporean neurosurgical unit. J Clin Neurosci. 2013; 20(6): 867-72.
Lv LQ, Hou LJ, Yu MK, Qi XQ, Chen HR, Chen JX, et al. Risk factors related to dysautonomia after severe traumatic brain injury. J Trauma. 2011; 71(3): 538-42.
Mazzini L, Cossa FM, Angelino E, Campini R, Pastore I, Monaco F. Posttraumatic epilepsy: Neuroradiologic and neuropsychological assessment of long-term outcome. Epilepsia. 2003; 44(4): 569-74.
Murshid WR. Management of minor head injuries: Admission criteria, radiological evaluation and treatment of complications. Acta Neurochir (Wien). 1998; 140(1): 56-64.
Nasi D, Dobran M, Di Rienzo A, di Somma L, Gladi M, Moriconi E, et al. Decompressive craniectomy for traumatic brain injury: The role of cranioplasty and hydrocephalus on outcome. World Neurosurg. 2018; 116: e543-e549.
Pachatouridis D, Alexiou GA, Mihos E, Fotakopoulos G, Voulgaris S. The value of programmable shunt valves for the management of subdural collections in patients with hydrocephalus. ScientificWorldJournal. 2013; 2013: 461896.
Pechmann A, Anastasopoulos C, Korinthenberg R, van Velthoven-Wurster V, Kirschner J. Decompressive craniectomy after severe traumatic brain injury in children: Complications and outcome. Neuropediatrics. 2015; 46(1): 5-12.
Phuenpathom N, Ratanalert S, Saeheng S, Sripairojkul B. Post-traumatic hydrocephalus: Experience in 17 consecutive cases. J Med Assoc Thai. 1999; 82(1): 46-53.
Hu Q, Di G, Shao X, Zhou W, Jiang X. Predictors Associated with post-traumatic hydrocephalus in patients with head injury undergoing unilateral decompressive craniectomy. Front Neurol. 2018; 9: 337.
Roka YB, Kumar P, Bista P, Sharma GR, Adhikari P. Traumatic posterior fossa extradural haematoma. JNMA J Nepal Med Assoc. 2008; 47(172): 174-8.
Ryan ME, Jaju A, Ciolino JD, Alden T. Rapid MRI evaluation of acute intracranial hemorrhage in pediatric head trauma. Neuroradiology. 2016; 58(8): 793-9.
Sakr S, Azzazi A, Elsayed AA, Fathalla H. Surgical management of penetrating intracranial bullet injuries. Neurosurg Q. 2014; 26(1): 37-41.
Silva Neto AR, Valenca MM. Transcalvarial brain herniation volume as a predictor of posttraumatic hydrocephalus after decompressive craniectomy. Clin Neurol Neurosurg. 2019; 182: 73-8.
Shi SS, Zhang GL, Zeng T, Lin YF. Posttraumatic hydrocephalus associated with decompressive cranial defect in severe brain-injured patients. Chin J Traumatol. 2011; 14(6): 343-7.
Su TM, Lee TH, Huang YH, Su FW, Chen WF. Contralateral subdural effusion after decompressive craniectomy in patients with severe traumatic brain injury: Clinical features and outcome. J Trauma. 2011; 71(4): 833-7.
Su TM, Lan CM, Lee TH, Hsu SW, Tsai NW, Lu CH. Risk factors for the development of posttraumatic hydrocephalus after unilateral decompressive craniectomy in patients with traumatic brain injury. J Clin Neurosci. 2019; 63: 62-7.
Takeuchi S, Takasato Y, Masaoka H, Hayakawa T, Yatsushige H, Shigeta K, et al. Hydrocephalus following decompressive craniectomy for ischemic stroke. Acta Neurochir Suppl. 2013; 118: 289-91.
Tian HL, Xu T, Hu J, Cui YH, Chen H, Zhou LF. Risk factors related to hydrocephalus after traumatic subarachnoid hemorrhage. Surg Neurol. 2008; 69(3): 241-6.
Vadivelu S, Effendi S, Starke JR, Luerssen TG, Jea A. A review of the neurological and neurosurgical implications of tuberculosis in children. Clin Pediatr (Phila). 2013; 52(12): 1135-43.
Whyte J, Nordenbo AM, Kalmar K, Merges B, Bagiella E, Chang H, et al. Medical complications during inpatient rehabilitation among patients with traumatic disorders of consciousness. Arch Phys Med Rehabil. 2013; 94(10): 1877-83.
Yang XF, Wen L, Shen F, Li G, Lou R, Liu WG, et al. Surgical complications secondary to decompressive craniectomy in patients with a head injury: a series of 108 consecutive cases. Acta Neurochir (Wien). 2008; 150(12): 1241-7.
Yilmazlar S, Kocaeli H, Dogan S, Abas F, Aksoy K, Korfali E, et al. Traumatic epidural haematomas of nonarterial origin: Analysis of 30 consecutive cases. Acta Neurochir (Wien). 2005; 147(12): 1241-8.
Yoon SY, Choi YJ, Park SH, Hwang JH, Hwang SK. Traumatic brain injury in children under age 24 months: Analysis of demographic data, risk factors, and outcomes of post-traumatic seizure. J Korean Neurosurg Soc. 2017; 60(5): 584-90.
Yuan Q, Wu X, Yu J, Sun Y, Li Z, Du Z, et al. Subdural hygroma following decompressive craniectomy or non-decompressive craniectomy in patients with traumatic brain injury: Clinical features and risk factors. Brain Inj. 2015; 29(7-8): 971-80.
Sarkari A, Gupta DK, Sinha S, Kale SS, Mahapatra AK. Post-traumatic hydrocephalus: Presentation, management and outcome-An apex trauma centre experience. Indian J Neurotrauma. 2010; 7(2): 135-8.
Yerramneni V, Kotha V. Posttraumatic hydrocephalus: risk factors, treatment modalities, and prognosis. Indian J Neurosurg. 2017; 06(03): 198-202.
Goldschmidt E, Angriman F, Jha RM, Zusman B, Puccio A, Okonkwo DO. Incidence and risk factors for developing post-traumatic hydrocephalus, analysis of a prospective cohort of 402 patients. Neurosurgery. 2019; 66(Suppl 1): 310-687.
Honeybul S, Ho KM. Incidence and risk factors for post-traumatic hydrocephalus following decompressive craniectomy for intractable intracranial hypertension and evacuation of mass lesions. J Neurotrauma. 2012; 29(10): 1872-8.
Choi I, Park HK, Chang JC, Cho SJ, Choi SK, Byun BJ. Clinical factors for the development of posttraumatic hydrocephalus after decompressive craniectomy. J Korean Neurosurg Soc. 2008; 43(5): 227-31.
Dewan MC, Rattani A, Gupta S, Baticulon RE, Hung YC, Punchak M, et al. Estimating the global incidence of traumatic brain injury. J Neurosurg. 2018; 130(4): 1080-97.
Roozenbeek B, Maas AI, Menon DK. Changing patterns in the epidemiology of traumatic brain injury. Nat Rev Neurol. 2013; 9(4): 231-6.
Le TH, Gean AD. Neuroimaging of traumatic brain injury. Mt Sinai J Med. 2009; 76(2): 145-62.
