Objective:

To discuss and examine the mechanisms of post-traumatic hydrocephalus (PTH) development in adults, predictors of its outcome/progression, and the modalities and effectiveness of its surgical management.

Approach:

• Literature Review: A comprehensive review of relevant literature on PTH.
• Retrospective Analysis: A single-center retrospective analysis of a cohort of adult PTH patients over 1 year.

Key Findings:

• PTH occurred in 20 (21.05%) out of a series of 95 patients who sustained a TBI for 1 year.
• Acute subdural hematoma was present in 14 (70.0%) of PTH patients.
• Midline shift/cisternal compression was found in 13 (65.0%) of PTH patients.
• Low admission Glasgow Coma Score (GCS), severe TBI, and older age correlated with increased intracranial pressure (ICP) and unfavorable outcomes.

Interpretation:

Low admission GCS, acute subdural hematoma, brain edema, elevated ICP, and older age are strong predictors of unfavorable outcomes in TBI patients who develop PTH.

Limitations:

• The study is based on a single-center retrospective analysis, which may limit generalizability.
• The clinical presentation of PTH is often atypical, complicating diagnosis.

Conclusion:

Only PTH patients with increased ICP require unconditional surgery, while those with chronic symptoms may be observed for progression.