[Posthaemorrhagic hydrocephalus in newborns--current concepts of formation and treatment possibilities].
Intracranial haemorrhage is still one of major complications of preterm birth. Transfontanel ultrasonographic examination is a recognized method of peri/intraventricular haemorrhage imaging. Haemorrhages are distinguished according to four degrees Papile classification. Early diagnosis of posthaemorrhagic hydrocephalus is a very important task for neonatologist. Traditional clinical symptoms of ventricular expansion are useless criteria for posthaemorrhagic hydrocephalus diagnosis. Early diagnosis of posthaemorrhagic hydrocephalus is possible with ultrasonographic measurement of ventricular size--for example with ventricular index of Levine. There are four mechanisms responsible for posthaemorrhagic hydrocephalus formation: blockage of cerebro-spinal fluid circulation and its absorption, fibrosis and scarring around the medulla and in subarachnoid spaces and endogenic fibrinolytic mechanisms insufficiency. Authors decribe current known and used methods of neonatal and neurosurgical interventions in posthaemorrhagic hydrocephalus, as well as a new method involving drainage, irigation and fibrinolytic therapy (DRIFT), which seems to be promising in clinical neonatal care.
Klinika Intensywnej Terapii i Patologii, Noworodka Slaskiej Akademii Medycznej w Katowicach, Górnoślaskie Centrum Zdrowia Dziecka i Matki, Katowice. jolkurz@hotmail.com
Jolanta
J
Wróblewska
Janusz
J
Swietliński
D004322:Drainage; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology* / Q000628:therapy*; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D020300:Intracranial Hemorrhages / Q000150:complications*
D005343:Fibrinolytic Agents