Consensus-based recommendations for diagnosis and surgical management of cranioplasty and post-traumatic hydrocephalus from a European panel

•Clinical diagnosis after cranial decompression should rely on evolving symptoms and neuro-psychological tests rather than on a static score.•Radiological diagnosis should be based on the evolving CT and MRI findings, ith flexible use of the Evan's index.•Cranioplasty planning in decompressed patients should adopt a cautious and delayed approach if hydrocephalus diagnosis is required.•To determine the need for a ventriculo peritoneal shunt, it is recommended cranial reconstruction first, and serial clinical and radiological follow-ups then.•When a shunt insertion is necessary, a programmable valve is the preferred choice.