title: Ventriculoperitoneal shunt as a primary neurosurgical procedure in newborn posthemorrhagic hydrocephalus: report of a series of 47 shunted patients.
abstract: OBJECTIVE
  Intraventricular hemorrhage is the most common cause of infantile acquired hydrocephalus. Our objective is to determine if the implantation of ventriculoperitoneal shunt in posthemorrhagic hydrocephalus as a primary and definitive neurosurgical treatment, with no previous temporary procedures, would decrease complication rates with good functional outcomes.
  
  
  METHODS
  Two hundred seventy-one patients with germinal matrix hemorrhage were diagnosed at the Carlos Haya Hospital between 2003 and 2010. Forty-seven patients underwent ventriculoperitoneal shunt after developing symptomatic hydrocephalus. The minimum weight required for shunt implantation was 1,500 g. We recorded complications related to the surgical procedure and analyzed functional state with a self-developed four-grade scale.
  
  
  RESULTS
  One hundred thirty-nine (51.3 %) patients with intraventricular hemorrhage developed ventricular dilatation, but only 47 patients (17.34 %) needed shunting. In seven cases, temporary neurosurgical procedures were performed, but in all of them, this was followed by ventriculoperitoneal shunt implantation. The infection rate was 4.25 %, and shunt obstruction rate was 4.25 %. More than 80 % of patients were classified as good or excellent functional state. Mean follow-up period was 38.75 months (SD, 27.09; range, 1-102 months).
  
  
  CONCLUSIONS
  Ventriculoperitoneal shunting as a primary neurosurgical treatment in posthemorrhagic hydrocephalus would decrease surgical morbidity with good functional outcome.
authors.affiliation: Department of Neurosurgery, HRU Carlos Haya, Málaga, Spain, lorenaromeromoreno@gmail.com.
authors.forename: L
authors.initials: L
authors.lastname: Romero
authors.forename: B
authors.initials: B
authors.lastname: Ros
authors.forename: F
authors.initials: F
authors.lastname: Ríus
authors.forename: L
authors.initials: L
authors.lastname: González
authors.forename: J M
authors.initials: JM
authors.lastname: Medina
authors.forename: A
authors.initials: A
authors.lastname: Martín
authors.forename: A
authors.initials: A
authors.lastname: Carrasco
authors.forename: M A
authors.initials: MA
authors.lastname: Arráez
mesh_terms: D002543:Cerebral Hemorrhage / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006849:Hydrocephalus / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D019635:Neurosurgical Procedures / Q000379:methods; D011247:Pregnancy; D014463:Ultrasonography; D017287:Ventriculoperitoneal Shunt / Q000379:methods*