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The Rabbit Blood-shunt Model for the Study of Acute and Late Sequelae of Subarachnoid Hemorrhage: Technical Aspects
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Posthemorrhagic hydrocephalus in low-birth-weight infants: treatment by serial lumbar punctures

L A Papile, J Burstein, R Burstein

    The Journal of Pediatrics
    |August 1, 1980
    PubMed

    Insights

    Serial lumbar punctures effectively arrested hydrocephalus progression in low-birth-weight infants with intraventricular hemorrhage. This method showed no complications, unlike shunt surgery which had 100% morbidity.

    Area of Science:

    • Neonatal Neurology
    • Pediatric Neurosurgery
    • Medical Imaging

    Background:

    • Intraventricular hemorrhage (IVH) is a common complication in low-birth-weight infants.
    • Acute ventricular dilatation and evolving hydrocephalus can occur post-IVH.
    • Hydrocephalus management in neonates presents significant challenges.

    Purpose of the Study:

    • To evaluate the efficacy of serial lumbar punctures in managing post-hemorrhagic hydrocephalus in low-birth-weight infants.
    • To compare the outcomes of serial lumbar punctures with surgical intervention for hydrocephalus.
    • To assess the complication rates associated with serial lumbar punctures versus shunting.

    Main Methods:

    • Weekly computed tomographic (CT) brain scans were performed on 28 low-birth-weight infants with IVH and ventricular dilatation.
    • Fifteen infants developed evolving hydrocephalus.
    • Twelve of these infants were treated with serial lumbar punctures to remove cerebrospinal fluid.

    Main Results:

    • Arrest in hydrocephalus progression was observed in 11 out of 12 infants treated with serial lumbar punctures.
    • Only one treated infant required surgical intervention, compared to all three untreated infants.
    • Serial lumbar punctures had no noted complications, while shunt placement resulted in 100% morbidity.

    Conclusions:

    • Serial lumbar punctures are an effective conservative treatment for arresting post-hemorrhagic hydrocephalus in neonates.
    • This minimally invasive approach offers a favorable safety profile compared to surgical shunting.
    • Lumbar punctures represent a viable alternative to shunting in managing neonatal hydrocephalus post-IVH.

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