• Cesar Carballo-Cuello, Orlando de Jesus, Ricardo J Fernandez-de Thomas, Maria Garcia, Juan Vigo-Prieto, and Aixa de Jesus-Espinosa.
• Section of Neurosurgery, School of Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico, USA.
• World Neurosurg. 2020 Apr 1; 136: e690-e694.

ObjectiveThe risk for developing posttraumatic hydrocephalus (PTH) is higher when patients undergo decompressive craniectomy as part of their treatment. The purpose of this study is to determine the prevalence of PTH after decompressive craniectomy in pediatric patients and determine associated risk factors that may lead to PTH.MethodsA retrospective analysis was conducted by searching the Puerto Rico neurologic surgery database from 2010 to 2019. All pediatric patients (1-18 years old) at the University Pediatric Hospital of the Puerto Rico Medical Center who had traumatic brain injury and had a decompressive craniectomy were included in the study. Data were reviewed to determine if time to decompressive craniectomy, side of decompressive craniectomy, gender, mechanism of trauma, amount of subarachnoid hemorrhage, and time to cranioplasty were risk factors for the development of PTH.ResultsIncidence of PTH after decompressive craniectomy was 21%. Neither gender, side of decompressive craniectomy, mechanism of trauma, amount of subarachnoid hemorrhage, time from trauma to decompressive craniectomy, nor cranioplasty intervention had statistical significance for developing PTH. Time from decompressive craniectomy to cranioplasty was significant for development of PTH.ConclusionsLonger time to cranioplasty was associated with an increased likelihood of PTH. We recommend performing cranioplasty as soon as possible to reduce hydrocephalus development.Copyright © 2020 Elsevier Inc. All rights reserved.

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