Objective: The literature describes various cerebrospinal fluid (CSF) drainage techniques to alleviate posthemorrhagic hydrocephalus in preterm newborns; however, consensus has not been reached. The scope of this study was describing a case series of premature neonates with posthemorrhagic hydrocephalus and assessing the outcomes of different approaches used for CSF diversion. Methods: A consecutive review of the medical records of neonates with posthemorrhagic hydrocephalus treated with CSF drainage was conducted. Results: Forty premature neonates were included. Serial lumbar puncture, ventriculosubgaleal shunt, and ventriculoperitoneal shunt were the treatments of choice in 25%, 37.5% and 37.5% of the cases, respectively. Conclusion: Cerebrospinal fluid diversion should be tailored to each case with preference given to temporary CSF drainage in neonates with lower age and lower birth-weight, while the permanent ventriculoperitoneal shunt should be considered in healthier, higher birth-weight neonates born closer to term.Keywords: cerebral hemorrhage; hydrocephalus; cerebrospinal fluid. RESUMOObjetivo: A literatura descreve várias opções de drenagem liquórica (DL) para alivio da hidrocefalia pós-hemorrágica (HPH) em neonatos prematuros; contudo, não existe um consenso sobre a melhor abordagem. O escopo deste estudo foi descrever uma série de casos de neonatos prematuros, portadores de HPH, verificando os resultados de diferentes técnicas utilizadas para DL. Métodos: Revisão consecutiva dos prontuários de neonatos com diagnostico de HPH submetidos a DL. Resultados: Quarenta recém-nascidos prematuros foram incluídos. A punção lombar seriada (PL), a derivação ventriculosubgaleal (VSG) e a derivação ventrículo peritoneal (VP) foram o tratamento escolhido em 25%, 37,5% e 37,5% dos casos, respectivamente. Conclusão: As opções de DL devem ser avaliadas caso a caso, sendo dada preferência às drenagens temporária em prematuros com idade e peso mais baixos ao nascer, enquanto o shunt definitivo (derivação VP) pode ser considerado naqueles prematuros mais saudáveis, com idade e peso superiores.Palavras-chave: hemorragia cerebral; hidrocefalia; líquido cefalorraquidiano. Intraventricular hemorrhage (IVH) has been a major cause of mortality among premature neonates for more than 40 years 1,2 and is associated with neonatal encephalopathy, subsequent subtle apnea, and death 1,2,3,4 . Low birth-weight premature neonates are more vulnerable to IVH and, depending on the IVH grade, to posthemorrhagic hydrocephalus (PHH). Posthemorrhagic hydrocephalus can evolve to progressive PHH, and in more severe cases, to periventricular hemorrhagic infarct, hemorrhagic cerebral injury, and periventricular leukomalacia 1,4,5 . Between 15% to 20% of neonates born with a weight less than 1,500 g are estimated to develop IVH. Further, 75% of those with Papile grade III or IV hemorrhages develop progressive PHH and need a permanent shunt 4,6 .The literature does not clearly indicate any standardized protocols for the best PHH treatment o...

Objective Hydrocephalus is one of the main complications associated with myelomeningocele (MM). This study aimed to identify clinical and ultrasonographic criteria for using ventriculoperitoneal (VP) shunts in this group of patients.Method A retrospective cohort study, based on established protocol for VP shunt implant in hydrocephalic children with MM. Parameters used to guide the indication of VP shunts included measurement of head circumference (HC), evaluation of fontanels, and measurement of lateral ventricular atrium (LVA) width by transcranial ultrasonography.Results 43 children were included in the analysis, of which 74% had hydrocephalus and required a VP shunt. These children had LVA width ≥ 15 mm, showed increased HC, or had bulging fontanels.Conclusion VP shunt is required in children with increased HC (≥ 2 standard deviation regarding age group), bulging fontanels, or LVA width of ≥ 15 mm after the closure of MM.