Surgical management of posthemorrhagic hydrocephalus in 22 low-birth-weight infants.
In order to assess the complication rates of cerebrospinal fluid diversion techniques used at our institution, a retrospective study of the surgical management of posthemorrhagic hydrocephalus was conducted from a population of 547 premature infants admitted to the neonatal intensive care unit from 1987 to 1989. The incidences of periventricular-intraventricular hemorrhage in the 3 years studied were 44%, 37%, and 27%, respectively. Thirty-nine of the infants developed posthemorrhagic hydrocephalus as determined by serial cranial ultrasonography; 22 required cerebrospinal fluid diversion. During the study period, we began using subcutaneous ventricular reservoirs and a low-pressure Neonatal Shunt (customized device) in infants weighing less than 1500 g at the time of instrumentation. This change in management was associated with a significant reduction (P < 0.005) in the morbidity and mortality compared to the use of external ventricular drainage devices. On the basis of these findings, the use of external ventricular drainage devices was discontinued.
Gurtner
P
P
Department of Neurosurgery, Eastern Virginia Medical School, Norfolk 23507.
Bass
T
T
Gudeman
S K
SK
Penix
J O
JO
Philput
C B
CB
Schinco
F P
FP
D002543:Cerebral Hemorrhage / Q000150:complications*; D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects / Q000295:instrumentation*; D004867:Equipment Design; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D010537:Peritoneum; D015996:Survival Rate