Isotope Liquorgraphy in the Demonstration of Communicating Obstructive Hydrocephalus After Severe Cranial Trauma

The incidence of hydrocephalus communicans obstructivus (HCO) complicating severe cranial trauma appears to be significant. In the present material, HCO was demonstrated in 9 out of 28 patients, while in another 5 cases there was some evidence of HCO under development. The diagnosis cannot be established on clinical grounds alone, but must be based on repeated pneumoencephalographic and liquorgraphic examinations. These examinations are indicated in patients with severe cranial trauma, resulting in a period of unconsciousness of long duration, and also in such patients manifesting an arrest in expected clinical improvement. Indications for ventriculoatrial shunting are present when CVR and/or an absence of parasagittal filling are demonstrated on liquorgraphy, and, in addition, progressive HCO is seen on repeated pneumoencephalographic examinations.