To summarize the epidemiology, mechanisms, risk factors, diagnostic advances, and treatment strategies for post-traumatic hydrocephalus (PTH) to improve clinical recognition and management.
Approach:
Methods: A narrative literature review was conducted using major medical databases to identify clinical, imaging, and experimental studies addressing incidence, pathophysiology, diagnosis, and therapy of PTH.
Key Findings:
PTH occurs across injury severities and is associated with subarachnoid hemorrhage, decompressive craniectomy, infection, and advanced age.
Proposed mechanisms include cerebrospinal fluid circulation disturbance, impaired absorption, neuroinflammation, and altered intracranial compliance.
Diagnostic accuracy has improved with advanced neuroimaging and dynamic cerebrospinal fluid assessment.
Therapeutic approaches have evolved from conventional shunting to individualized strategies incorporating endoscopic techniques and adjustable shunt systems.
Interpretation:
PTH remains underdiagnosed due to heterogeneous presentations. Future efforts should focus on standardized diagnostic criteria and early risk stratification, integration of glymphatic and aquaporin-4 pathways, biomarker- and AI-guided diagnostics, and mechanism-targeted preventive strategies.
Limitations:
PTH is often underdiagnosed due to its heterogeneous presentations.
There is a lack of standardized diagnostic criteria and prognostic assessments.
The neurological recovery process in postoperative shunt-dependent patients is not well understood.
Conclusion:
This review provides a theoretical foundation for improving clinical practice in diagnosing and managing PTH.
