Ventriculosubgaleal shunt: a treatment option for progressive posthemorrhagic hydrocephalus.
Among premature infants born at less than 1500 g, the incidence of intraventricular hemorrhage is greater than 45%. Of these, 40% will develop progressive posthemorrhagic hydrocephalus (PPHH). Optimum treatment remains controversial. Ventriculosubgaleal (VSG) shunts were first proposed as a means of temporarily diverting cerebrospinal fluid (CSF) in a more physiological manner for those infants less than 1500 g in weight who would not tolerate a ventriculoperitoneal (VP) shunt. The VSG shunt could then be converted into a VP shunt when the infant had gained the desired weight. Despite favourable reports, the procedure has not gained universal acceptance and is unknown to many neurosurgeons. The present authors report a series of 15 patients who had VSG shunts inserted with excellent temporary CSF diversion and no complications. Furthermore, 3 out of the 15 patients required no further treatment. We suggest that VSG shunting is a safe and effective means of treating the premature infant with PPHH.
Rahman
S
S
Division of Pediatric Neurosurgery, Arkansas Children's Hospital, Little Rock 72202, USA.
Teo
C
C
Morris
W
W
Lao
D
D
Boop
F A
FA
D002543:Cerebral Hemorrhage / Q000150:complications*; D002552:Cerebral Ventricles / Q000601:surgery*; D002557:Cerebrospinal Fluid Shunts; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology / Q000601:surgery*; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D012535:Scalp / Q000601:surgery*