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Purpose To gain insight into the patient characteristics of surgically treated hydrocephalus in the Netherlands, we report the first data from the Dutch Quality Registry NeuroSurgery (QNRS) database for infants with hydrocephalus requiring surgical intervention. Methods We used the prospectively gathered database concerning infants ≤ 2 years of age surgically treated for hydrocephalus. We report data from start of registry, concerning etiology, age, and treatment of patients registered. We compared data with the Hydrocephalus Clinical Research Network (HCRN), a multicenter network of pediatric neurosurgical institutions in North America.Results A total of 359 operated infants was registered in the period from 2010 to 2017. A drop in patients registered was seen in 2015, possibly due to revisions of the database. Most infants were operated on between 1 and 6 months of age. Cause of hydrocephalus was predominantly intracranial hemorrhage, followed by congenital causes. The proportion of infants with aqueduct stenosis and myelomeningocele as cause of hydrocephalus stayed relatively stable during this period of registration. Initial shunting was performed in 40% and reservoir/ETV as initial treatment was done in 60%. In both groups, 50% needed revision surgery. Conclusions The first data concerning surgically treated pediatric hydrocephalus from a prospectively collected Dutch register are presented, showing similar results when comparing to the HCRN database.

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Evaluation of: Whitelaw A, Jary S, Kmita G et al.: Randomized trial of drainage, irrigation and fibrinolytic therapy for premature infants with posthemorrhagic ventricular dilatation: developmental outcome at 2 years. Pediatrics 125, E852–E858 (2010). The aim of the study was to determine in a randomized trial whether ventricle drainage, irrigation and fibrinolytic therapy (DRIFT) altered the rate of death or severe neurodevelopmental disability at 24 months’ corrected age in preterm infants with posthemorrhagic ventricular dilatation. Of the children assigned to DRIFT, 54% died or were severely disabled, versus 71% in the standard group. Among the survivors, 31% in the DRIFT group had severe cognitive disability (Mental Development Index score <55) versus 59% in the standard group. No differences were found in rates of children with Mental Development Index scores over 70. The study points to a potential meaningful intervention by removing toxic substances from hemorrhagic cerebrospinal fluid. Being a highly invasive intervention, however, further studies are required.