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Posthemorrhagic hydrocephalus in the preterm infant

E R Chaplin, G W Goldstein, D Z Myerberg

    Pediatrics
    |May 1, 1980
    PubMed

    Insights

    Delayed onset posthemorrhagic hydrocephalus in low birth weight infants has a poor long-term outlook. Medical therapy alone may arrest hydrocephalus in some cases, but shunt placement is often required.

    Area of Science:

    • Neonatal Neurology
    • Pediatric Neurosurgery
    • Developmental Pediatrics

    Background:

    • Delayed onset posthemorrhagic hydrocephalus is a serious complication in low birth weight infants following intracranial bleeding.
    • Clinical signs of hydrocephalus typically manifest after two weeks of age in affected infants.

    Purpose of the Study:

    • To evaluate the long-term outcomes of low birth weight infants treated for delayed onset posthemorrhagic hydrocephalus.
    • To compare the efficacy of surgical shunt placement versus medical management (lumbar puncture and diuretics) for this condition.

    Main Methods:

    • Retrospective analysis of 22 low birth weight infants treated between 1969 and 1978.
    • Group 1 (n=12): Treated with surgical shunt placement before August 1974.
    • Group 2 (n=10): Received medical therapy (lumbar puncture, diuretics) before shunt placement after September 1974.

    Main Results:

    • Seven of ten infants in Group 2 had hydrocephalus arrested with medical therapy alone.
    • Long-term follow-up (1-8 years) in 18 infants showed poor intellectual outcomes.
    • Only 2/12 shunt-treated and 3/6 medically-treated infants achieved an IQ score of 85 or greater.

    Conclusions:

    • Low birth weight infants developing clinically overt hydrocephalus after intracranial bleeding face a poor long-term prognosis.
    • While medical management can be successful in some cases, overall developmental outcomes remain a significant concern.
    • Further research is needed to improve management strategies and long-term neurodevelopmental outcomes for this vulnerable population.

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