Objective:

To review and identify risk factors associated with the development of post-traumatic hydrocephalus (PTH) following traumatic brain injury (TBI).

Approach:

• Study Design: Narrative review of literature focusing on risk factors associated with PTH after TBI.
• Literature Search: Searches conducted in EMBASE, PubMed, and Scopus from January 1950 to March 2026 using relevant keywords.
• Inclusion Criteria: Included observational studies, cohort studies, case-control studies, systematic reviews, and meta-analyses published in English.

Key Findings:

• Advanced age and comorbidities in adults are predisposing factors for PTH.
• Severity of initial brain injury and presence of subarachnoid and/or intraventricular hemorrhages increase PTH risk.
• Prolonged mechanical ventilation and vasopressor use are associated with PTH development.
• Decompressive craniectomy (DC) and its characteristics may influence PTH occurrence.
• The relationship between cranioplasty (CP) and PTH is controversial, with varying reports on its impact.

Interpretation:

Understanding predisposing factors for PTH may enhance early recognition and treatment, potentially improving outcomes for TBI patients.

Limitations:

• The pathophysiology of PTH remains poorly understood.
• Variability in reported incidence rates of PTH complicates risk factor identification.
• Diagnostic challenges exist in distinguishing symptomatic PTH from other conditions.

Conclusion:

Identifying risk factors for PTH is crucial for improving surveillance, diagnosis, and management of TBI patients.