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[Ventriculo subgaleal shunt in hydrocephalus secondary to intraventricular hemorrhage in prematures]

Antonio García-Méndez1, Leonardo Álvarez-Vázquez1, Fernando Agustín-Aguilar1

  • 1Servicio de Neurocirugía Pediátrica, Hospital General La Raza Dr. Gaudencio González, México, D.F.

Gaceta Medica De Mexico
|February 4, 2015
PubMed

Insights

Ventriculo subgaleal shunts effectively manage intraventricular hemorrhage (IVH) in premature infants, reducing infection rates and neurological sequelae. This method offers improved hydrocephalus control and better long-term outcomes for high-risk neonates.

Area of Science:

  • Neonatal Neurology
  • Pediatric Neurosurgery
  • Critical Care Medicine

Context:

  • Intraventricular hemorrhage (IVH) remains a significant complication in premature infants, with current incidence rates around 20%.
  • Managing IVH presents challenges due to diverse therapeutic options and potential for long-term neurological deficits.
  • Historical incidence of IVH in the 1970s-1980s was high (40-50%), highlighting the need for improved interventions.

Purpose:

  • To evaluate the efficacy of ventriculo subgaleal shunts in managing intraventricular hemorrhage in premature infants.
  • To assess the impact of gestational age, weight, and IVH grade on therapeutic decisions for shunt placement.
  • To analyze infection rates, mortality, and long-term neurological sequelae associated with ventriculo subgaleal shunts.

Summary:

  • A retrospective review of 48 premature infants treated with ventriculo subgaleal shunts was conducted.
  • The average gestational age for shunt placement was 30 months, with an average infant weight of 1,511g.
  • The study reported a 4% infection rate and 8% mortality, with no surgical mortality observed. 92% of survivors received a peritoneal shunt.

Impact:

  • Derivation using subgaleal shunts significantly reduces infection rates compared to historical data.
  • This approach allows for effective control of hydrocephalus, mitigating long-term neurological sequelae in premature infants.
  • The findings suggest ventriculo subgaleal shunts are a valuable therapeutic option for reducing morbidity and mortality in neonatal IVH.
Abstract

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