title: [Results of early external ventricular diversion in posthemorrhagic ventricular dilatation in the newborn].
abstract: OBJECTIVE
  The authors report the outcome of early treatment with long-term external ventricular drainage (EVD) of progressive post-hemorrhagic ventricular dilatation (PPHVD), following peri-intraventricular hemorrhage (PIVH) in a population of preterm newborns.
  
  
  METHODS
  Neonatal Intensive Care Unit (NICU) of a Children's Hospital.
  
  
  METHODS
  Twenty-one preterms of 29.6 +/- 2.4 weeks of gestational age, weighing at birth 1443 +/- 445 g, mechanically ventilated, submitted to early EVD because of PPHVD following PIVH of III (n 11) e IV (n 10) grade.
  
  
  METHODS
  PPHVD was diagnosed on the basis of US and TC findings. An external liquoral drainage suitable, for its technical characteristics, to be maintained for a long period of time and peculiar anesthesiologic, intra and postoperative treatments were utilized.
  
  
  RESULTS
  EVD was placed at 21 +/- 5.8 days of life and maintained for 40 +/- 16 days. In all cases reduction of ventricular size was observed. One case (5%) developed liquoral infection and recovered with antibiotic therapy. No obstruction or dislocation of the ventricular catheter occurred. During EVD 3 patients (14%) died because of respiratory complications. After the normalization of cerebrospinal fluid (CSF), a "permeability test" was performed to assess the canalization of the liquoral system. Seven patients (33.5%) underwent ventriculo-peritoneal shunt (VPS) and 11 (52.5%) became shunt-free.
  
  
  CONCLUSIONS
  Our results indicate that long-term use of EVD has a low risk of complications, avoids the need for transcutaneous tips and allows monitoring of CSF characteristics. Furthermore EVD protects the brain from liquoral hypertension, while waiting for a possible recurrence of natural CSF circulation, and is associated with a low number of definitive VPS.
authors.affiliation: Servizio di Anestesia e Rianimazione, Istituto G. Gaslini, Genova.
authors.forename: M L
authors.initials: ML
authors.lastname: Massone
authors.forename: A
authors.initials: A
authors.lastname: Cama
authors.forename: D
authors.initials: D
authors.lastname: Leone
authors.forename: E
authors.initials: E
authors.lastname: Pellas
authors.forename: R
authors.initials: R
authors.lastname: Vallarino
authors.forename: S
authors.initials: S
authors.lastname: Carini
authors.forename: L
authors.initials: L
authors.lastname: Andreussi
mesh_terms: D002543:Cerebral Hemorrhage / Q000150:complications*; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology / Q000601:surgery*; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000601:surgery*; D008297:Male; D014696:Ventriculostomy
vernacular_title: Risultati della derivazione ventricolare esterna precoce nella dilatazione ventricolare postemorragica del neonato.