New insights into the management of post-hemorrhagic hydrocephalus |
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| Affiliation: | 1. T.S. Park Chair and Chief of Pediatric Neurosurgery, Executive Vice Chair of Neurological Surgery, Washington University School of Medicine; Neurosurgeon-in-Chief, St. Louis Children''s Hospital;2. Em. Professor in Neonatal Neurology, Department of Neonatology, University Medical Center Utrecht and Leiden University Medical Center, the Netherlands;1. Neonatologist, Associate Professor of Pediatrics, Division of Neonatal-Perinatal Medicine, University of Texas Southwestern Medical Center;2. Neonatologist, Associate Professor of Pediatrics, Division of Neonatal-Perinatal Medicine, Children''s Mercy Hospital-Kansas City, University of Missouri-Kansas City School of Medicine;3. Director of the Children''s Mercy Bioethics Center, Professor of Pediatrics, Department of Pediatrics, Children''s Mercy Hospital-Kansas City, University of Missouri-Kansas City School of Medicine;1. Division of Pediatric Cardiology, Department of Pediatrics, Stanford University School of Medicine;2. Heart Institute, UPMC Children''s Hospital of Pittsburgh, Department of Pediatrics, University of Pittsburgh School of Medicine;1. Department of Neonatology, Cork University Maternity Hospital, Wilton, Cork, Ireland;2. Department of Paediatrics and Child Health, University College Cork, Wilton, Cork, Ireland;3. INFANT Research Centre, University College Cork, Wilton, Cork, Ireland;1. Duke Children''s Pediatric and Congenital Heart Center, Duke University Medical Center, Durham, NC, USA;2. Division of Pediatric Neurology, University of Maryland Medical Center, Baltimore, MD, USA;3. Division of Cardiology, Children''s National Hospital, Washington, DC, USA |
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| Abstract: | During the last decade, an increasing number of studies have been conducted to improve the outcome of post-hemorrhagic hydrocephalus (PHH), a complication of severe intraventricular hemorrhage (IVH) in preterm infants. Two randomized controlled trials have shown that treatment should be initiated prior to the onset of clinical symptoms. Ventricular access devices and subgaleal shunts are used as temporary neurosurgical interventions whereas ventriculoperitoneal shunts are performed for infants with progressive hydrocephalus. Recently, techniques such as neuro-endoscopic lavage have also been introduced to eliminate toxic blood products and debris from the cerebral ventricles and have shown promise in early clinical studies. The objective of this review is to provide an update on management of PHVD and PHH in the preterm infant. |
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