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Updated: Jun 1, 2026
Modeling Posthemorrhagic Hydrocephalus of Prematurity in Rats
Published on: March 28, 2025
Neurodevelopmental outcome of post-hemorrhagic ventricular dilatation at 12 and 24 months corrected age with
Sascha A van Zanten1, Timo R de Haan, Jennie Ursum
1Department of Neonatology, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands. savanzanten@gmail.com
Insights
Infants with post-hemorrhagic hydrocephalus (PHVD) often show poorer neurodevelopmental outcomes, especially those with Grade III intraventricular hemorrhage (IVH). Outcomes were worse with high-threshold therapy, particularly at 24 months corrected age.
Area of Science:
- Neonatal neuroscience
- Pediatric neurology
- Developmental pediatrics
Background:
- Post-hemorrhagic hydrocephalus (PHVD) management is debated.
- High-threshold therapy is one approach for infants with PHVD.
Purpose of the Study:
- To compare neurodevelopmental outcomes in premature infants with Grade III or IV intraventricular hemorrhage (IVH).
- To assess outcomes in infants with or without PHVD.
Main Methods:
- Retrospective review of infants with Grade III or IV IVH.
- Neurodevelopmental examinations at 12 and 24 months corrected age.
Main Results:
- PHVD developed in 75% of Grade III IVH and 42% of Grade IV IVH cases.
- Abnormal outcomes were more frequent in Grade III IVH with PHVD (64% at 24 months).
- Developmental delay was more pronounced at 24 months.
Conclusions:
- Grade III IVH cases were more likely to develop PHVD.
- Neurodevelopmental outcomes were poorer with high-threshold therapy compared to literature.
Background:
The management of post-hemorrhagic hydrocephalus remains a discussion. We describe the neurodevelopmental outcome at the corrected age of 12 and 24 months of infants with PHVD treated with high-threshold therapy.
Objective:
To describe, and compare the neurodevelopmental outcome of a cohort of premature infants with grade III or IV intraventricular hemorrhage with or without development of PHVD.
Methods:
Retrospective chart and image review of all IVH grade III and IV infants admitted to the department of Neonatology of the Academic Medical Center, Amsterdam, the Netherlands between January 1999 and December 2006. A standardized neurodevelopmental examination was performed at the corrected ages of 12 and 24 months.
Results:
In total, 118 cases with IVH were identified. IVH grade III: n = 63, mean gestational age (GA): 28 weeks (SD 2.3), median birth weight (BW): 1130 g (range 908-1460 g); IVH IV: n = 31, mean GA: 28 weeks (SD 2.4), median BW: 1105 g (range 925-1230 g). Grade III and IV cases developed PHVD in 75% versus 42% respectively. Abnormal outcome in IVH III patients mainly occurred in cases with PHVD (12 months: 47% abnormal, 24 months: 64% abnormal). In the IVH IV cases, outcome was comparable with or without PHVD. Developmental delay was more pronounced at 24 months.
Conclusion:
Mainly IVH III cases developed PHVD. Comparing our results with the literature neurodevelopmental outcome was poorer with our high-threshold therapy.
