scholarly journals Surgical management of intraventricular hemorrhage and posthemorrhagic hydrocephalus in premature infants

2020 ◽  
Vol 43 (3) ◽  
pp. 268-276 ◽  
Author(s):  
Meng-Fai Kuo
Keyword(s):  
Surgical Management ◽  
Premature Infants ◽  
Intraventricular Hemorrhage ◽  
Posthemorrhagic Hydrocephalus

scholarly journals Premature Infants with Intraventricular Hemorrhage and Perioperative Management of Neonatal Posthemorrhagic Hydrocephalus

2013 ◽  
Vol 22 (4) ◽  
pp. 276-282
Author(s):  
Masakazu Miyajima ◽  
Takaoki Kimura ◽  
Akihide Kondo ◽  
Kazuaki Shimoji ◽  
Hajime Arai
Keyword(s):  
Premature Infants ◽  
Intraventricular Hemorrhage ◽  
Perioperative Management ◽  
Posthemorrhagic Hydrocephalus

scholarly journals Anatomical configurations associated with posthemorrhagic hydrocephalus among premature infants with intraventricular hemorrhage

2016 ◽  
Vol 41 (5) ◽  
pp. E5 ◽  
Author(s):  
Hannah M. Tully ◽  
Tara L. Wenger ◽  
Walter A. Kukull ◽  
Dan Doherty ◽  
William B. Dobyns
Keyword(s):  
Premature Infants ◽  
Intraventricular Hemorrhage ◽  
Surgical Planning ◽  
Surgical Intervention ◽  
Brain Mri ◽  
Mr Images ◽  
Ventricular Dilation ◽  
Posthemorrhagic Hydrocephalus ◽  
The Mean ◽  
Grade Iii

OBJECTIVE Intraventricular hemorrhage (IVH) is a complication of prematurity often associated with ventricular dilation, which may resolve over time or progress to posthemorrhagic hydrocephalus (PHH). This study investigated anatomical factors that could predispose infants with IVH to PHH. METHODS The authors analyzed a cohort of premature infants diagnosed with Grade III or IV IVH between 2004 and 2014. Using existing ultrasound and MR images, the CSF obstruction pattern, skull shape, and brain/skull ratios were determined, comparing children with PHH to those with resolved ventricular dilation (RVD), and comparing both groups to a set of healthy controls. RESULTS Among 110 premature infants with Grade III or IV IVH, 65 (59%) developed PHH. Infants with PHH had more severe ventricular dilation compared with those with RVD, although ranges overlapped. Intraventricular CSF obstruction was observed in 36 (86%) of 42 infants with PHH and 0 (0%) of 18 with RVD (p < 0.001). The distribution of skull shapes in infants with PHH was similar to those with RVD, although markedly different from controls. No significant differences in supratentorial brain/skull ratio were observed; however, the mean infratentorial brain/skull ratio of infants with PHH was 5% greater (more crowded) than controls (p = 0.006), whereas the mean infratentorial brain/skull ratio of infants with RVD was 8% smaller (less crowded) than controls (p = 0.004). CONCLUSIONS Among premature infants with IVH, intraventricular obstruction and infratentorial crowding are strongly associated with PHH, further underscoring the need for brain MRI in surgical planning. Prospective studies are required to determine which factors are cause and which are consequence, and which can be used to predict the need for surgical intervention.

External ventricular drainage for control of posthemorrhagic hydrocephalus in premature infants

1981 ◽  
Vol 55 (5) ◽  
pp. 766-770 ◽  
Author(s):  
Robert E. Harbaugh ◽  
Richard L. Saunders ◽  
William H. Edwards
Keyword(s):  
Premature Infants ◽  
Intraventricular Hemorrhage ◽  
External Ventricular Drainage ◽  
Ventricular Drainage ◽  
Medical Problems ◽  
Posthemorrhagic Hydrocephalus ◽  
Content Type ◽  
The Mean ◽  
Tunneled Catheter ◽  
Initial Method

✓ Over a 3-year period, 11 premature infants with intraventricular hemorrhage and posthemorrhagic hydrocephalus were managed initially with prolonged external ventricular drainage via a subcutaneously tunneled catheter. The mean duration of drainage for this group was 20.7 days. Although two patients died before shunting was considered, no morbidity or mortality was observed to result from this technique. Seven patients required a shunt after stabilization of their medical problems. Two patients, followed for 24 and 40 months, have not required shunting procedures. External ventricular drainage via a subcutaneously tunneled catheter has been found to be a safe and reliable initial method of treating posthemorrhagic hydrocephalus in premature infants.

scholarly journals Surgical management of hydrocephalus secondary to intraventricular hemorrhage in the preterm infant

2016 ◽  
Vol 17 (3) ◽  
pp. 278-284 ◽  
Author(s):  
Eisha A. Christian ◽  
Edward F. Melamed ◽  
Edwin Peck ◽  
Mark D. Krieger ◽  
J. Gordon McComb
Keyword(s):  
Los Angeles ◽  
Preterm Infant ◽  
Surgical Management ◽  
Premature Infants ◽  
Shunt Infection ◽  
Ventricular Catheter ◽  
Posthemorrhagic Hydrocephalus ◽  
Shunt Placement ◽  
Initial Procedure ◽  
Csf Diversion

OBJECT Posthemorrhagic hydrocephalus (PHH) in the preterm infant remains a major neurological complication of prematurity. The authors first described insertion of a specially designed low-profile subcutaneous ventricular catheter reservoir for temporary management of hydrocephalus in 1983. This report presents the follow-up experience with the surgical management of PHH in this population and describes outcomes both in infants who were stable for permanent shunt insertion and those initially temporized with a ventricular reservoir (VR) prior to permanent ventriculoperitoneal (VP)/ventriculoatrial (VA) shunt placement. METHODS A retrospective review was undertaken of the medical records of all premature infants surgically treated for posthemorrhagic hydrocephalus (PHH) between 1997 and 2012 at Children’s Hospital Los Angeles. RESULTS Over 14 years, 91 preterm infants with PHH were identified. Fifty neonates received temporizing measures via a VR that was serially tapped for varying time periods. For the remaining 41 premature infants, VP/VA shunt placement was the first procedure. Patients with a temporizing measure as their initial procedure had undergone CSF diversion significantly earlier in life than those who had permanent shunting as the initial procedure (29 vs 56 days after birth, p < 0.01). Of the infants with a VR as their initial procedure, 5/50 (10%) did not undergo subsequent VP/VA shunt placement. The number of shunt revisions and the rates of loculated hydrocephalus and shunt infection did not statistically differ between the 2 groups. CONCLUSIONS Patients with initial VR insertion as a temporizing measure received a CSF diversion procedure significantly earlier than those who received a permanent shunt as their initial procedure. Otherwise, the outcomes with regard to shunt revisions, loculated hydrocephalus, and shunt infection were not different for the 2 groups.

Blood Pressure and Intraventricular Hemorrhage in Premature Infants

PEDIATRICS ◽  
1990 ◽  
Vol 86 (6) ◽  
pp. 1006-1007
Author(s):  
EDWARD H. PERRY ◽  
HENRIETTA S. BADA ◽  
JOHN D. DAY ◽  
SHELDON B. KORONES ◽  
KRISTOPHER L. ARHEART ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Birth Weight ◽  
Premature Infants ◽  
Intraventricular Hemorrhage ◽  
Stability Boundary ◽  
Mean Blood Pressure ◽  
Pressure Increase ◽  
Blood Pressure Increase ◽  
The Mean

In Reply.— We appreciate the interest and comments of Drs Puccio and Soliani regarding our article "Blood Pressure Increase, Birth Weight Dependent Stability Boundary and Intraventricular Hemorrhage."1 In response, we address the following points: 1. Although mean blood pressure (BP) values greater than 100 mm Hg were observed in some of our patients, these were quite rare. The mean BP was found to be less than 60 mm Hg 99% of the time. Thus, unless one is recording BPs through long periods and sampling quite often, the brief spikes likely would not be observed.

Blood Pressure and Intraventricular Hemorrhage in Premature Infants

PEDIATRICS ◽  
1990 ◽  
Vol 86 (6) ◽  
pp. 1006-1006
Author(s):  
V. F. PUCCIO ◽  
M. SOLIANI
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Critically Ill ◽  
High Blood Pressure ◽  
Intracranial Hemorrhage ◽  
Premature Infants ◽  
Intraventricular Hemorrhage ◽  
Mean Blood Pressure ◽  
Central Topic ◽  
Safe Blood

To the Editor.— We have read with great interest the recently published article by Perry et al.1 The need to define "safe" blood pressure levels in the critically ill premature infants is a central topic in the prevention of intracranial hemorrhage. However, in Perry's paper maximum systolic blood pressure and maximum mean blood pressure values are much higher than those reported by previously published articles.2-4 High blood pressure values were reported by Lou and Friis-Hansen5 in nine newborns.

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