1212 - From CT to Shunt and Beyond: The Value of Physiatry in Recognition and Management of Hydrocephalus after Brain Injury

Saturday, October 22, 2022

10:00 AM – 11:15 AM ET

Location: 343-344

Session Director(s)

Nathan Darji, DO (he/him/his)

Assistant Professor, Brain Injury Division
Atrium Health Carolinas Rehabilitation
Charlotte, North Carolina

Disclosed no relevant financial relationships.

Faculty(s)

CI

Cindy Ivanhoe, MD

Clinical Professor, Physical Medicine and Rehabilitation McGovern Medicine School
TIRR-Memorial Hermann
Houston, Texas

Disclosed no relevant financial relationships.
MD

Mark Dannenbaum, MD

Assistant Professor of Neurosurgery
UT McGovern Medical School

Disclosed no relevant financial relationships.

Communicating hydrocephalus after brain injury is an underdiagnosed and undertreated clinical phenomenon. It has been reported that up to 73% of patients with post-traumatic hydrocephalus present in the rehabilitation setting (Kammersagaard et al, 2013). Physiatrists must lead the way in recognizing and advocating for the treatment of hydrocephalus in order to promote rehabilitation and the best possible outcomes for patients afflicted by a brain injury. It is imperative that physiatrists be equipped with the skills to recognize the subtle presentations of hydrocephalus and communicate and advocate to neurosurgeons for definitive treatment of CSF diversion.

This session will educate the audience on the clinical manifestations of normal pressure hydrocephalus after acquired brain injury. Normal and abnormal CSF dynamics, behavioral and cognitive manifestations of hydrocephalus, diagnostic measures including radiographic and clinical features, and neurosurgical considerations will be discussed.

References:
Kammersgaard LP, Linnemann M, Tibæk M. Hydrocephalus following severe traumatic brain injury in adults. Incidence, timing, and clinical predictors during rehabilitation. NeuroRehabilitation. 2013;33(3):473-80. doi: 10.3233/NRE-130980. Erratum in: NeuroRehabilitation. 2017;41(4):831. PMID: 23949078.

Learning Objectives:

As a result of attending this session, participants will be able to understand risk factors, timing of presentation, and impact on rehabilitation outcomes of hydrocephalus after brain injury.
As a result of attending this session, participants will be able to understand and apply clinical tools to be able to recognize and diagnose hydrocephalus after brain injury.
As a result of attending this session, participants will be able to understand neurosurgical considerations for the treatment of hydrocephalus after brain injury, including shunt types and complications.

Presentations:

Introduction, Background, and Neurosurgical Considerations
Speaker: Nathan B. Darji, DO (he/him/his) – Atrium Health Carolinas Rehabilitation
Clinical Manifestations & Philosphy of Care
Speaker: Cindy B. Ivanhoe, MD – TIRR-Memorial Hermann