J Korean Neurosurg Soc.  2023 May;66(3):274-280. 10.3340/jkns.2022.0265.

Temporary Surgical Management of Intraventricular Hemorrhage in Premature Infants

• Park EK
• Kim JY
• Kim DS
• Shim KW

• KMID: 2542012
• DOI: http://doi.org/10.3340/jkns.2022.0265

Abstract

Post-hemorrhagic hydrocephalus (PHH) in preterm infant is common, life-threatening and the main cause of bad developmental outcomes. Ventriculoperitoneal (VP) shunt is used as the ultimate treatment for PHH. Low birth weight and low gestational age are the combination of worse prognostic factors while the single most important prognostic factor of VP shunting is age. Aggressive and early intervention have better effect in intraventricular hemorrhage and intracranial pressures control. It reduces infection rate and brain damage resulted in delayed shunt insertion. It is extremely important to let PHH infants get older and gain weight to have internal organs to be matured before undergoing VP shunt. As premature infants undergo shunt after further growth, shunt-related complications would be reduced. So temporary surgical intervention is critical for PHH infants to have them enough time until permanently shunted.

Keyword

Neuroendoscope ∙ Infant, premature ∙ Hemorrhage ∙ Hydrocephalus

Figure

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  Fig. 1. Neurosonography at the time when the patient was transferred to our hospital. Left side dominant encephalomalacia and posthemorrhagic hydrocephalus were seen. a : Right ventricle in midline sagittal view. b : More dilated left ventricle in midline sagittal view. C and D : asymmetric size of ventricles in coronal views.

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  Fig. 2. Noncontrast brain magnetic resonance imaging T2 weighted image (dark signals on left side of brain are artifacts from programmable valve). a : The day of ventriculoperitoneal (VP) shunt insertion. Destructed left hemisphere and marked hydrocephalus were seen. b : after 10 months from the VP shunt insertion. No significant other abnormalities (such as hemorrhage, mass, hydrocephalus, ischemic lesion) were seen. The size of the ventricle was decreased.

Reference

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