Treatment of post-haemorrhage ventricular dilatation with an Ommaya's reservoir: management and outcome of 64 preterm infants.
Over a 5-year period, an Ommaya's reservoir has been inserted in a single neurosurgical centre in each of 64 preterm infants with post-haemorrhage ventricular dilatation (PHVD). Their mean gestational age at birth was 29.2 weeks. The average age at reservoir insertion was 24 days. Seventeen infants received a fibrinolytic agent through the reservoir. Infections occurred in 14 patients. Two patients died after handling of their reservoirs. Thirty-one of the 45 survivors required a shunt placement. After a follow-up ranging from 6 months to more than 4 years, 17 of 43 patients have severe sequelae or are handicapped. Compared with the results of other studies, our experience does not suggest that treatment of PHVD with an Ommaya's reservoir is beneficial in term of mortality, shunt placement, and/or neurological outcome. The place of Ommaya's reservoir among the various means of managing PHVD should be carefully evaluated, as should the best way of using this appliance safely.
Richard
E
E
Service de Pédiatrie et Réanimation Néonatales (UPRES EA 2704), Hôpital Antoine-Béclère, Assistance-Publique/Hôpitaux de Paris, Clamart, Paris, France.
Cinalli
G
G
Assis
D
D
Pierre-Kahn
A
A
Lacaze-Masmonteil
T
T
D002408:Catheters, Indwelling; D002543:Cerebral Hemorrhage / Q000401:mortality / Q000601:surgery*; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006849:Hydrocephalus / Q000401:mortality / Q000601:surgery*; D007223:Infant; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000401:mortality / Q000601:surgery*; D008297:Male; D009460:Neurologic Examination; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000401:mortality; D012189:Retrospective Studies; D015996:Survival Rate; D014696:Ventriculostomy / Q000295:instrumentation*