Primary intervention for posthemorrhagic hydrocephalus in very low birthweight infants by ventriculostomy
| Autor: | Axel Heep, A. M. Holschneider, R. Engelskirchen, P. Groneck |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Ventriculostomy
medicine.medical_specialty medicine.medical_treatment Remission Spontaneous Gestational Age Ventriculoperitoneal Shunt Cerebrospinal fluid medicine Ventriculitis Humans Infant Very Low Birth Weight Cerebral Hemorrhage Cerebrospinal Fluid Retrospective Studies Intracranial pressure medicine.diagnostic_test Lumbar puncture business.industry Infant Newborn Gestational age General Medicine medicine.disease Surgery Hydrocephalus Subdural hygroma Anesthesia Pediatrics Perinatology and Child Health Neurology (clinical) business |
| Zdroj: | Child's Nervous System. 17:47-51 |
| ISSN: | 1433-0350 0256-7040 |
| DOI: | 10.1007/s003810000363 |
| Popis: | The objective of our study was to determine the efficacy of ventriculostomy as the primary treatment for posthemorrhagic hydrocephalus in premature infants. Within a period of 4 years, 20 very low birthweight (VLBW) infants (birthweight median 1,135 g, range 650-1,470 g) were treated for progressive posthemorrhagic hydrocephalus (PHHC) by right parietal ventriculostomy (Salmon Rickham) at a mean age of 21 days. Serial tapping of the subcutaneous reservoir was performed for temporary drainage until conversion to a permanent ventriculoperitoneal (VP) shunt or spontaneous resolution of hydrocephalus. A total of 1,402 punctures (median 71/infant, range 13-168) was performed. The results showed that only 1/20 patients developed a cerebrospinal fluid (CSF) infection, accounting for a 5% patient-related and 0.07% procedure-related infection rate. Major complications such as skin defects, subdural hygroma, or CSF leaks occurred in three patients (15%). A permanent shunt was needed in 17 patients (85%). We concluded that, as an effective alternative to serial or lumbar puncture, there should be early implantation of ventriculostomy reservoirs for serial taps to control intracranial pressure in PHHC of VLBW infants until a permanent shunt can be placed because of the low incidence of infections and technical complications. |
| Databáze: | OpenAIRE |
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