CLINICAL OBSERVATIONS ON HYDROCEPHALUS WITH SPECIAL REGARD TO POSTTRAUMATIC MALRESORPTIVE FORM

Cases of Spitz-Holter shunts (100) performed for hydrocephalus over a period of 3 yr were analyzed; 17 of these were of posttraumatic origin and were discussed in regard to pathogenesis, clinical symptoms, diagnostic methods and therapy. Half of these 17 had severe traffic accidents. The rapidity and degree of ventricular dilatation were positively correlated with the duration of unconsciousness. When the unconsciousness lasted more than 10 days hydrocephalus was recognized early, and the shunt was performed on an average, 2 mo. after the trauma. Of the patients 2/3 improved after the shunt operation. The important factors in the acute stages probably were increased CSF pressure, disturbed CSF dynamics, brain swelling and vascular circulation disorder; in the chronic stages, parenchymous atrophy. Three types of posttraumatic hydrocephalus were differentiated on the basis of the clinical features.