COMPARATIVE ANALYSIS OF NEUROSURGICAL ASPECTS OF NEONATAL INTRAVENTRICULAR HEMORRHAGE TREATMENT

Intraventricular hemorrhage is the major cause for neonatal hydrocephalus. This study aims to provide the comparative analysis of existing methods of intraventricular hemorrhage treatment. 39 medical cases were studied retrospectively, all the patients were treated at Neonatology Department of O. Ghudushauri National Medical Center, in 2016-2020. As an initial neurosurgical intervention, 23 and 11 neonates underwent ventricular reservoir implantation (A) and ventriculostomy (B), respectively; 5 newborns received the serial ventricular/lumbar punctures (C). Complications, eventual need for shunting, the frequency of intracranial cyst formation and the rate of complication with meningitis were studied retrospectively. The patients were divided into three groups - A, B and C. The Group A, Group B and Group C neonates slightly differed by the gestational ages. In Group A, 17 (73.91%) newborns required shunting during their stay at the clinic, and 2 of them were transferred abroad for further treatment. In group B, 8 newborns required shunting and 2 patients died. In Group C, ventriculoperitoneal shunting was applied in 100% of cases. Among 39 patients, shunting was required for 30 (76.92%) neonates, 2 out of whom were transferred abroad. 7 (17,98%) patients died. The average number of neurosurgical interventions among the deceased patients was 2 (minimum 1, maximum 5). Complications of the neonate intraventricular hemorrhage pose a serious threat to life and further neurological development. There is no optimum method for treatment of this disease, each case requires differentiated approach and individual identification of treatment tactics.