Post-traumatic hydrocephalus is best defined as accumulation of CSF due to disruption of absorption or drainage. What is a typical treatment?

• A. Ventriculoperitoneal shunt
• B. Diuretic therapy
• C. External auditory drainage
• D. Endoscopic third ventriculostomy

Answer: (A)

Post-traumatic hydrocephalus often becomes a communicating form, where CSF absorption is impaired after injury. The key way to treat this is to divert CSF away from the ventricles so pressure and buildup are relieved. A ventriculoperitoneal shunt does exactly that: a catheter is placed into the ventricle and drains CSF to the peritoneal cavity where it can be absorbed, providing a long-term solution to the excess CSF.

Diuretic therapy is not a durable fix for hydrocephalus because it only modestly reduces CSF production and doesn’t address the blocked or slowed drainage. External drainage through the ear is not a mechanism for CSF management. Endoscopic third ventriculostomy creates a bypass in non-communicating (obstructive) hydrocephalus by opening the floor of the third ventricle, which isn’t the typical scenario in post-traumatic hydrocephalus where the issue is absorption/dysfunction of drainage rather than an obstruction. Hence, the standard, typical treatment is a ventriculoperitoneal shunt.