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Rapidly progressive posthemorrhagic hydrocephalus. Treatment with external ventricular drainage
American Journal of Diseases of Children (1960)
|July 1, 1984
Summary
External ventricular drainage temporarily controlled progressive hydrocephalus in premature infants. While effective, most infants later required ventriculoperitoneal shunts for long-term management of increased intracranial pressure.
Area of Science:
- Neonatal Medicine
- Pediatric Neurosurgery
- Neurology
Background:
- Posthemorrhagic hydrocephalus is a serious complication in premature infants.
- Increased intracranial pressure poses significant risks to neurological development.
Purpose of the Study:
- To evaluate the efficacy of external ventricular drainage (EVD) as a temporizing measure.
- To assess outcomes in premature infants with progressive hydrocephalus treated with EVD.
Main Methods:
- Nineteen premature infants with progressive posthemorrhagic hydrocephalus underwent EVD.
- Hydrocephalus progression was monitored during the drainage period.
Main Results:
- EVD arrested hydrocephalus progression in all 19 infants during treatment.
- 16 infants experienced recurrence and subsequently received ventriculoperitoneal shunts.
- Seven of 16 survivors had a developmental quotient >75; poorest outcomes were associated with intracerebral hemorrhage.
Conclusions:
- EVD is an effective temporizing measure for premature infants with severe hydrocephalus when shunting is not immediately feasible.
- It allows for ventricular decompression and can facilitate later, more favorable shunt placement.
- Careful monitoring and management are crucial for optimizing outcomes in this vulnerable population.