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Acquired aqueductal stenosis in preterm infants: an indication for neuroendoscopic third ventriculostomy
D Scavarda1, N Bednarek, F Litre
1Department of Pediatric Neurosurgery, Hôpital des Enfants, La Timone, 13385 Marseille Cedex 05, France. didier.scavarda@ap-hm.fr
Object:
The object of this study is to demonstrate the delayed occurrence of aqueductal stenosis in preterm infants who have suffered from intraventricular hemorrhage (IVH) and to try to explain the mechanisms of this stenosis.
Method:
From January 1996 to June 2002, 1,046 premature infants were admitted to our institution. Thirty-six neonates suffered from grade 3 or 4 intraventricular hemorrhage (Papile grading), of whom 16 died. Twenty patients survived and a ventriculoperitoneal shunt was inserted in 7 infants. Four patients underwent a neuroendoscopic third ventriculostomy. Follow-up was carried out, twice a month during the first 2 months and subsequently twice a year.
Conclusion:
In 2 children NTV was an effective treatment for hydrocephalus with an average follow-up of 29 months. The specific pattern concerning these patients is the long delay before obstructive hydrocephalus and the visualization of de novo obstruction with MRI. The biological explanation must be investigated.