J Korean Neurosurg Soc.  2023 May;66(3):281-288. 10.3340/jkns.2023.0044.

Permanent Surgical Treatment for Posthemorrhagic Hydrocephalus in Preterm Infants

• Harada A

• KMID: 2542013
• DOI: http://doi.org/10.3340/jkns.2023.0044

Abstract

While the standard management for posthemorrhagic hydrocephalus (PHH) has not been determined, many patients initially receive temporary treatment such as a ventricular drainage, a ventricular reservoir, or a ventriculosubgaleal shunt. Subsequently, approximately 15% of patients with PHH will require permanent cerebrospinal fluid diversion. Shunt placement is most commonly performed for PHH as permanent treatment. However, shunting still has high complication rates. Since the development of the neuroendoscopic technique has progressed, and indication has been expanded, endoscopic third ventriculostomy with or without choroid plexus cauterization has performed more frequently in recent years in patients with PHH. In this paper, the permanent treatment for PHH will be reviewed based on the latest evidence.

Keyword

Preterm infants; Intraventricular hemorrhage; Ventriculoperitoneal shunt; Endoscopic third ventriculostomy; Posthemorrhagic hydrocephalus

Figure

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  Fig. 1. Case presentation. A : Ultrasonography at the age of 1 day (left) and 28 days (right) demonstrating bilateral intraventricular hemorrhage developing to ventricular dilatation. B : T2-weighted magnetic resonance images at the age of 4 months before shunt operation showing enlargement of the ventricle. C : Lateral view of X-ray after shunt operation with a programmable valve.

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  Fig. 2. Strategy for the permanent treatment for posthemorrhagic hydrocephalus. CSF : cerebrospinal fluid, VP : ventriculo-peritoneal, ETV : endoscopic third ventriculostomy, CPC : choroid plexus cauterization.

Reference

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