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Isolated ventricles following intraventricular hemorrhage
Insights
Progressive hydrocephalus in premature infants after intraventricular hemorrhage can lead to isolated ventricles. Multiple shunts are often necessary to manage this complex condition, requiring close monitoring with imaging techniques.
Area of Science:
- Neonatal Neurology
- Pediatric Neurosurgery
Background:
- Intraventricular hemorrhage (IVH) is a common complication in premature neonates.
- Panventricular enlargement and hydrocephalus can develop following IVH.
- Standard treatments like lumbar punctures and ventricular reservoirs may be insufficient.
Abstract:
Panventricular enlargement often follows intraventricular hemorrhage in the premature neonate. During a recent 12-month period, the authors identified five infants who required shunting because of symptomatic post-hemorrhagic hydrocephalus, which was progressive despite serial lumbar punctures and the use of indwelling subcutaneous ventricular reservoirs. In the first 6 months following placement of the initial shunt, four of the infants required an additional shunt for isolated ventricles. Two children had isolation of the lateral ventricles and required bilateral shunts. Two other children had isolation of the fourth ventricle from the lateral ventricular system and required posterior fossa shunts. All of the children were treated successfully using multiple shunts. In all cases, progressive dilation of the isolated ventricle was unaccompanied by the usual clinical signs of shunt malfunction. It appears that isolated ventricular systems are common following post-hemorrhagic hydrocephalus and these children must be followed closely with ultrasound and computerized tomography scanning.