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Post-traumatic hydrocephalus (PTH) occurs in 7.6\u201336% of cases, and early diagnosis significantly improves rehabilitation outcomes. This retrospective study analyzed risk factors for shunt-dependent PTH in 126 TBI patients (93 men, 33 women, median age 53 years). Patients were divided into those requiring shunts and those who did not. Clinical and radiological characteristics, including volumetric measurements and surgical techniques, were assessed using SPSS\n                    <jats:sup>\u00ae<\/jats:sup>\n                    Statistics 25. The incidence of shunt-dependent PTH was 27%. Multivariate analysis identified significant risk factors: advanced age at craniectomy (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.008; OR 1.048), traumatic subarachnoid hemorrhage in the basal cisterns (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.015; OR 7.545), post-traumatic ischemic infarcts (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.003; OR 5.319), transcalvarial brain herniation (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.012; OR 5.543), subdural hygroma (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.004; OR 8.131), and progression of contusion hemorrhages (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.013; OR 4.386). Operative parameters did not show statistical significance. Neurological outcomes in shunt patients, assessed via the modified Rankin Scale and Extended Glasgow Outcome Scale, were significantly worse than in non-shunt patients (mRS\u2009&gt;\u20093, GOS-E\u2009&lt;\u20095,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.001\u20130.011). Our findings suggest that subarachnoid hemorrhage in the cisterns, advanced age, hygromas, ischemic infarcts, transcalvarial herniation, and contusion hemorrhage progression are independent risk factors for shunt-dependent PTH. Additionally, shunt placement was linked to poorer neurological outcomes.\n                  <\/jats:p>","DOI":"10.1007\/s10143-025-03673-0","type":"journal-article","created":{"date-parts":[[2025,6,21]],"date-time":"2025-06-21T04:51:00Z","timestamp":1750481460000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Post-traumatic hydrocephalus after decompressive craniectomy: a multidimensional analysis of clinical, radiological, and surgical risk factors"],"prefix":"10.1007","volume":"48","author":[{"given":"S\u00e9rgio Miguel Fernandes","family":"Romualdo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tareq Adnan","family":"Juratli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilker","family":"Ey\u00fcpoglu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Schackert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Dengl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Prem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mido Max","family":"Hijazi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerim-Hakan","family":"Sitoci-Ficici","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,6,21]]},"reference":[{"key":"3673_CR1","doi-asserted-by":"publisher","first-page":"e29738","DOI":"10.7554\/eLife.29738","volume":"6","author":"M Absinta","year":"2017","unstructured":"Absinta M, Ha S-K, Nair G, Sati P, Luciano NJ, Palisoc M, Louveau A, Zaghloul KA, Pittaluga S, Kipnis J, Reich DS (2017) Human and nonhuman primate meninges harbor lymphatic vessels that can be visualized noninvasively by MRI. eLife 6:e29738. https:\/\/doi.org\/10.7554\/eLife.29738","journal-title":"eLife"},{"key":"3673_CR2","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1007\/s10143-024-02291-6","volume":"47","author":"M Al Masri","year":"2024","unstructured":"Al Masri M, Corell A, Micha\u00eblsson I, Jakola AS, Skoglund T (2024) The glymphatic system for neurosurgeons: a scoping review. 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