Post‑Traumatic Hydrocephalus

Overview

Post‑Traumatic Hydrocephalus (PTH) is a neurological condition in which cerebrospinal fluid (CSF) builds up in the brain following a traumatic brain injury (TBI). This can lead to increased pressure in the brain, changes in consciousness, movement difficulties, and cognitive decline. It may occur weeks or even months after the original injury.

At The Royal Buckinghamshire Hospital, we support adults recovering from PTH with consultant-led inpatient neurorehabilitation, whether or not they have undergone shunt surgery. Our goal is to restore mobility, cognition, and independence.

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What Causes Post-Traumatic Hydrocephalus?

PTH occurs when the normal circulation or absorption of CSF is disrupted following trauma, leading to ventricular enlargement (dilated fluid spaces in the brain).

Causes include:

• Traumatic brain injury (TBI) – especially moderate to severe
• Subarachnoid haemorrhage
• Subdural or epidural haematoma
• Post-surgical or post-shunt complications
• Brain swelling or scarring obstructing CSF flow

Unlike congenital hydrocephalus, PTH is acquired and can develop subacutely after injury. It may be underdiagnosed, especially in patients with complex recovery paths.

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Symptoms of Post-Traumatic Hydrocephalus

Symptoms can be subtle and often overlap with other effects of brain injury. However, a classic symptom cluster to watch for includes:

Physical Symptoms

• Gait disturbance – slow, unsteady, or shuffling walk
• Balance problems and frequent falls
• Urinary incontinence or urgency

Cognitive & Behavioural Changes

• Slowed thinking
• Memory difficulties
• Apathy or reduced motivation
• Confusion or reduced awareness

Other Symptoms

• Headache
• Drowsiness or fatigue
• Visual disturbances
• Speech changes

If untreated, hydrocephalus may lead to long-term functional decline or permanent disability.

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Diagnosis

Diagnosis of PTH typically involves:

• MRI or CT scan – to assess ventricular enlargement
• Lumbar puncture – to test CSF pressure or perform drainage
• Neuropsychological assessment – to track cognitive and behavioural changes
• Gait analysis – to observe walking pattern and balance
• Referral to neurosurgery may be required if shunting is being considered

PTH may improve with ventriculoperitoneal (VP) shunt placement or CSF drainage. Rehabilitation is crucial before and after surgical intervention.

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Rehabilitation at The Royal Buckinghamshire Hospital

We provide inpatient neurorehabilitation for patients recovering from brain injury with or without hydrocephalus. Our multidisciplinary team works together to create a tailored plan of care.

Services Include:

Physiotherapy

• Gait and balance retraining
• Strength and postural work
• Falls prevention strategies
• Vestibular support (if dizziness is present)

Occupational Therapy

• Activities of daily living (washing, dressing, home skills)
• Memory, attention and organisational aids
• Routine building and cognitive structuring
• Return to hobbies and community life

Neuropsychology

• Cognitive assessment and rehabilitation
• Behavioural and emotional support
• Goal setting and adjustment therapy
• Family education and support

Specialist Nursing Care

• 24/7 monitoring of neurological status
• Medication management
• Continence and skin care
• Shunt site monitoring (if applicable)

Speech and Language Therapy

• Language support (if affected by TBI)
• Cognitive-communication therapy
• Swallowing assessments (if indicated)

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Who We Can Help

We accept adults (18+) who:

• Are recovering from moderate or severe brain injury
• Have a confirmed or suspected diagnosis of post-traumatic hydrocephalus
• May or may not have had shunt surgery
• Are experiencing changes in walking, cognition or continence
• Require multidisciplinary neurorehabilitation

Call 01296 678800 or enquire online to speak with our admissions team.

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Why Choose The Royal Buckinghamshire Hospital?

• Expertise in complex neurological rehabilitation
• Dedicated programmes for brain injury recovery
• On-site neuropsychology and therapy 7 days a week
• Comfortable, private environment with ensuite rooms
• Family education and discharge planning included