title: Rapidly progressive enlargement of the fourth ventricle in the preterm infant with post-haemorrhagic ventricular dilatation.
abstract: Six preterm infants who developed disproportionate enlargement of the 4th ventricle during the neonatal period, associated with post-haemorrhagic ventricular dilatation (PHVD), before shunt placement are reported. Five of the six preterm infants developed cyanotic spells and/or bradycardias at the time of rapid enlargement of the 4th ventricle, suggestive of raised posterior fossa pressure, which resolved following insertion of and drainage from a subcutaneous reservoir. In one of the three survivors an isolated 4th ventricle was subsequently diagnosed later in infancy, requiring drainage. These data suggest that a combination of an enlarged 4th ventricle on ultrasound and cyanotic spells and/or bradycardias should lead to rapid release of raised pressure in the posterior fossa. Long-term follow-up of these children is necessary, as isolation of the 4th ventricle can subsequently develop.
authors.affiliation: Department of Neonatology, Wilhelmina Children's Hospital, Utrecht, The Netherlands.
authors.forename: K J
authors.initials: KJ
authors.lastname: Rademaker
authors.forename: P
authors.initials: P
authors.lastname: Govaert
authors.forename: W P
authors.initials: WP
authors.lastname: Vandertop
authors.forename: R
authors.initials: R
authors.lastname: Gooskens
authors.forename: L C
authors.initials: LC
authors.lastname: Meiners
authors.forename: L S
authors.initials: LS
authors.lastname: de Vries
mesh_terms: D002543:Cerebral Hemorrhage / Q000150:complications*; D002552:Cerebral Ventricles / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D004108:Dilatation, Pathologic / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases; D008279:Magnetic Resonance Imaging; D008297:Male; D010547:Persistent Fetal Circulation Syndrome / Q000150:complications; D011014:Pneumonia / Q000150:complications / Q000151:congenital; D012127:Respiratory Distress Syndrome, Newborn / Q000150:complications; D014463:Ultrasonography; D017287:Ventriculoperitoneal Shunt