Post-traumatic Hydrocephalus in Children: Pathophysiology and classification

Abstract

The specific nature of post-traumatic hydrocephalus occurring in the young immature brain was analyzed and classified into several categories on a pathophysiological basis. A hydrocephalic state developed in 12 cases (2.8%) out of 428 children admitted with head injury. Hydrocephalus tended to occur more often in the younger age group and the mean age was 4.4 years. All had either brain contusion or an acute subdural hematoma, and all except one child revealed a Glasgow Coma Scale or Children’s Coma Scale value of 8 or less. The time from injury to the diagnosis of hydrocephalus ranged from one and a half hours to 5 years. The different categories of post-traumatic hydrocephalus in these children were pathophysiologically classified as follows: acute hematohydrocephalus, acute hydrocephalus without massive cerebral edema, acute hydrocephalus with massive cerebral edema, subacute hydrocephalus, slowly progressive hydrocephalus, arrested hydrocephalus, unilateral progressive hydrocephalus and slit ventricle syndrome. This study emphasized that the physiological and anatomical characteristics of the young immature brain play significant roles in the development of these unique forms of hydrocephalus in traumatized children.