[Acute traumatic hydrocephalus].

Abstract

We have experienced two rare cases of acute traumatic hydrocephalus which developed within several hours after head injury. Case 1. A 4-year-old boy was stuck by an automobile. After losing consciousness for a few minutes, he became agitated and vomited. He was brought to our hospital 3 hours after accident. On admission, he scored 8 points on the Glasgow Coma Scale. CT scan on admission disclosed slightly enlarged ventricles, but there were no findings indicating cerebral contusion nor intracranial hemorrhage. His state of consciousness gradually deteriorated, thereafter right sided convulsive seizures occurred. 7 hours after accident, CT scan was repeated and demonstrated a marked enlargement of the ventricles. Continuous ventricular drainage was performed. The ventricular fluid was slightly bloody. After the ventricular drainage, the state of consciousness improved rapidly. 6 days after the accident, ventricular drainage was discontinued. Afterward, size and shape of the ventricles became nearly normal and the patient was discharged 36 days after the head injury without any neurological deficits. Case 2. A 3-year-old girl was buried under a burden. 30 minutes after the accident, her consciousness began to deteriorate with vomiting. She was brought to our hospital 3 hours after the accident. On her arrival, she scored 13 points on Glasgow Coma Scale. CT scan, which performed 4.5 hours after the accident, showed slightly enlarged ventricles and intraventricular hemorrhage in the third and fourth ventricles. Her state of consciousness gradually worsened with generalized seizures. Repeated CT scan 8 hours after the accident, demonstrated a marked enlargement of the ventricles. Following ventricular drainage, the patient's state of consciousness improved rapidly.(ABSTRACT TRUNCATED AT 250 WORDS)