Related Experiment Videos
Unilateral posthaemorrhagic hydrocephalus in the neonatal period or later in infancy
L S de Vries1, F Groenendaal, R Gooskens
1Department of Neonatology, Wilhelmina Children's Hospital, Utrecht, The Netherlands. l.devries@wkz.azu.nl
Insights
Unilateral hydrocephalus can develop in infants after intraventricular hemorrhage (IVH), even after initial stabilization. Regular cranial ultrasounds are crucial for early detection during the first year of life.
Area of Science:
- Pediatric Neurology
- Neonatal Medicine
- Neuroimaging
Background:
- Intraventricular hemorrhage (IVH) is a significant concern in neonates.
- Unilateral hydrocephalus is a potential complication following IVH.
Observation:
- Five infants with unilateral hydrocephalus following antenatal or perinatal IVH were studied.
- In four cases, hydrocephalus manifested after hospital discharge, with two receiving prior neonatal interventions.
- Obstruction at the foramen of Monro secondary to subependymal matrix bleeds was the identified cause.
Findings:
- Infants with predominantly unilateral IVH, with or without brain tissue involvement, are at risk for developing unilateral hydrocephalus.
- This condition can emerge even after a period of clinical and sonographic stability.
Implications:
- Repeated cranial ultrasound examinations are recommended throughout the first year of life for at-risk infants.
- This monitoring strategy aids in the timely diagnosis and management of delayed-onset unilateral hydrocephalus.
Abstract:
Five infants who developed unilateral hydrocephalus associated with antenatal or perinatal intraventricular haemorrhage (IVH) in the neonatal period or later in infancy are reported. Unilateral hydrocephalus occurred following discharge home in four of our five cases, two of whom had been treated during the neonatal period with either serial lumbar punctures or punctures from a Rickham reservoir. An obstruction at the level of the foramen of Monro following a large subependymal matrix bleed appeared to be the underlying aetiology. These data suggest that infants who suffer a predominantly unilateral IVH, with or without parenchymal involvement, can subsequently develop unilateral hydrocephalus. Cranial ultrasound examinations should be repeated at regular intervals during the first year of life, as unilateral hydrocephalus can still develop after a period of apparent stabilization.