Background Post-traumatic hydrocephalus (PTH) is potentially under-diagnosed and under-treated, generating the need for a more efficient diagnostic tool. We aim to report CSF dynamics of patients with post-traumatic ventriculomegaly. Materials and methods We retrospectively analysed post-traumatic brain injury (TBI) patients with ventriculomegaly who had undergone a CSF infusion test. We calculated the resistance to CSF outflow (Rout), AMP (pulse amplitude of intracranial pressure, ICP), dAMP (AMPplateau-AMPbaseline) and compensatory reserve index correlation coefficient between ICP and AMP (RAP). To avoid confounding factors, included patients had to be non-decompressed or with cranioplasty > 1 month previously and Rout > 6 mmHg/min/ml. Compliance was assessed using the elasticity coefficient. We also compared infusion-tested TBI patients selected for shunting versus those not selected for shunting (consultant decision based on clinical and radiological assessment and the infusion results). Finally, we used data from a group of shunted idiopathic Normal Pressure Hydrocephalus (iNPH) patients for comparison. Results Group A consisted of 36 patients with post-traumatic ventriculomegaly and Group B of 45 iNPH shunt responders. AMP and dAMP were significantly lower in Group A than B (0.55 ± 0.39 vs 1.02 ± 0.72; p < 0.01 and 1.58 ± 1.21 vs 2.76 ± 1.5; p < 0.01. RAP baseline was not significantly different between the two. Elasticity was higher than the normal limit in all groups (average 0.18 1/ml). Significantly higher Rout was present in those with probable PTH selected for shunting compared with unshunted. Mild/moderate hydrocephalus, ex-vacuo ventriculomegaly/encephalomalacia were inconsistently reported in PTH patients. Conclusions Rout and AMP were significantly lower in PTH compared to iNPH and did not always reflect the degree of hydrocephalus or atrophy reported on CT/MRI. Compliance appears reduced in PTH.

中文翻译：

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非急性创伤后脑室扩大的脑脊液动力学


背景 创伤后脑积水 (PTH) 可能未被充分诊断和治疗，因此需要更有效的诊断工具。我们的目的是报告创伤后脑室扩大患者的脑脊液动态。材料和方法 我们回顾性分析了接受脑脊液输注试验的脑室扩大的创伤后脑损伤 (TBI) 患者。我们计算了脑脊液流出阻力（Rout）、AMP（颅内压脉搏幅度，ICP）、dAMP（AMPplateau-AMPbaseline）以及ICP和AMP之间的代偿储备指数相关系数（RAP）。为了避免混杂因素，纳入的患者必须未减压或 1 个月前接受颅骨成形术 >，并且 Rout > 6 mmHg/min/ml。使用弹性系数评估依从性。我们还比较了选择进行分流的经过输注测试的 TBI 患者与未选择进行分流的患者（顾问决策基于临床和放射学评估以及输注结果）。最后，我们使用一组分流的特发性正常压力脑积水 (iNPH) 患者的数据进行比较。结果 A 组由 36 名患有创伤后脑室扩大的患者组成，B 组由 45 名 iNPH 分流反应者组成。 A 组的 AMP 和 dAMP 显着低于 B 组（0.55 ± 0.39 vs 1.02 ± 0.72；p < 0.01 和 1.58 ± 1.21 vs 2.76 ± 1.5；p < 0.01。两组之间的 RAP 基线没有显着差异。弹性为与未分流的轻度/中度脑积水相比，PTH 患者的 Rout 值均高于正常限值（平均 0.18 1/ml）。 。 结论 与 iNPH 相比，PTH 中的 Rout 和 AMP 显着降低，并且并不总是反映 CT/MRI 报告的脑积水或萎缩程度。 PTH 的依从性似乎降低。