Computerized tomography was performed on 100 consecutive patients suffering from severe head injury, on admission, after 3, 5, 14, and 90 days and 1 year. Ventricular enlargement was evaluated in the surviving patients based upon serial CT examinations. The presence or absence of ventricular enlargement was correlated with the clinical outcome. The study indicates that a significant correlation does exist between the outcome and ventricular size. Hydrocephalus was seen in only four out of the 29 patients who developed ventriculomegaly.
Ventricular enlargement is a well-recognized delayed complication of head injury [5,15]. This enlargement may be secondary to diffuse brain injury, to obstruction in the CSF pathways or a combination of the two. Focal enlargement may also occur following infarction. The incidence of ventricular enlargement due to hydrocephalus or other causes following head injury is variously reported in the CT literature to range between 1.5% and 8% [2,10,12]. The CT reports are, however, based upon an analysis of findings in patients with varying degrees of head injury. Furthermore, CT was performed at varying time intervals following head trauma. Thus, an accurate assessment of the incidence of ventriculomegaly and its relationship to clinical outcome is not possible from these reports.
We have undertaken a study to evaluate the development of ventricular enlargement due to hydrocephalus or diffuse brain damage following severe head injury in 100 consecutive patients using serial computed tomography. The purpose of this communication is to discuss the incidence of post-traumatic ventricular enlargement and its relationship to the ultimate clinical outcome.