Posthemorrhagic hydrocephalus and brain injury in the preterm infant: Dilemmas in diagnosis and management

Plessis, Adré J. du

doi:10.1016/s1071-9091(98)80032-6

Cited by 38 publications

(19 citation statements)

References 234 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…PHH is a major complication of IVH and contributes importantly to subsequent long-term cognitive and motor disability (2)(3)(4)(5). The management of infants with PHH is controversial because the benefits of any specific treatment regimen have not been established (2,(5)(6)(7)(8). However, substantial data from experimental animal studies of hydrocephalus suggest that impairments in cerebral hemodynamics and oxidative metabolism play a significant role in the pathophysiology of brain injury associated with this disorder (1).…”

mentioning

confidence: 99%

CSF Removal in Infantile Posthemorrhagic Hydrocephalus Results in Significant Improvement in Cerebral Hemodynamics

et al. 2004

View full text Add to dashboard Cite

mentioning

confidence: 99%

CSF Removal in Infantile Posthemorrhagic Hydrocephalus Results in Significant Improvement in Cerebral Hemodynamics

et al. 2004

View full text Add to dashboard Cite

“…The mechanism of brain injury in PHH is uncertain, but hydrocephalus is thought to produce compression of the periventricular white matter and eventually a reduction in circulation, leading to hypoxia/ischemia and then cell death [9]. Therefore, several researchers have investigated markers of hypoxia and cell death in the CSF of patients with PHH.…”

Section: Resultsmentioning

confidence: 99%

“…More slowly progressive PHH is likely caused by inflammatory changes around the CSF pathways, gliosis, and arachnoiditis [9]. Several factors are thought to contribute to brain injury in infants with IVH and PHH.…”

Section: Introductionmentioning

confidence: 99%

“…Several factors are thought to contribute to brain injury in infants with IVH and PHH. Damage to the germinal matrix and hypoxia-ischemia, both possibly mediated by cytotoxins from blood products, are presumed to be the main mechanisms of injury after IVH [9]. Physical stress to the white matter due to ventricular distension is thought to cause brain injury in PHH.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Biomarkers in Neonatal Posthemorrhagic Hydrocephalus

Merhar

2011

Neonatology

View full text Add to dashboard Cite

Posthemorrhagic hydrocephalus (PHH) is a rare but serious outcome among premature babies in the NICU, with consequences including mortality and severe neurodevelopmental disabilities. The causes of PHH are still not entirely understood, and its prevention and treatment are controversial. Various cerebrospinal fluid biomarkers have been studied in infants with PHH in order to recognize the causes, diagnose brain injury, and predict neurodevelopmental outcomes. This systematic review summarizes studies on biomarkers of extracellular matrix activity, fibrinolysis/coagulation, hypoxia/cell death, and inflammation in the cerebrospinal fluid of infants with PHH.

show abstract

“…I ntraventricular haemorrhage (IVH) occurs in 10-20% of all infants with a birth weight of less than 1000 g. [1][2][3][4][5][6] Development of posthaemorrhagic hydrocephalus (PHHC) is seen in 5% of these patients. [4][5][6][7][8] The underlying pathogenesis of hydrocephalus following IVH is not well understood.…”

mentioning

confidence: 99%

Procollagen I C-propeptide in the cerebrospinal fluid of neonates with posthaemorrhagic hydrocephalus

Heep

2002

Archives of Disease in Childhood - Fetal and Neonatal Edition

View full text Add to dashboard Cite

Background: The pathogenesis of posthaemorrhagic hydrocephalus (PHHC) following intraventricular haemorrhage (IVH) in premature infants includes a fibroproliferative reaction leading to arachnoidal fibrosis, ultimately causing malresorption of cerebrospinal fluid (CSF) at the arachnoid villi. Aims: To determine whether an increased concentration of the carboxyterminal propeptide of type I procollagen (PICP) in the CSF of neonates after IVH reflects the activation of collagen synthesis preceding the manifestation of PHHC. Methods: From 20 neonates with PHHC (median birth weight 740 g, median gestational age 25+1 weeks), 52 CSF samples were collected. CSF samples of four neonates (median birth weight 2170 g, median gestational age 32+4 weeks) with congenital non-haemorrhagic hydrocephalus served as controls. PICP was measured by radioimmunoassay. Results: PICP in CSF taken at the start of external CSF drainage (median day 21, range 17-25 days postnatal age) was significantly increased (median 851.5, range 153.5-1944 µg/l) compared with controls (median 136.1, range 33.8-169.5 µg/l). CSF concentrations of PICP declined until permanent shunt placement (median day 70, range days 41-113). Conclusion:In neonates who develop PHHC, significant elevation of PICP concentration in the CSF is present 3-4 weeks after IVH. It reflects the increase of local type I collagen turnover, thereby correlating with manifestation of PHHC. I ntraventricular haemorrhage (IVH) occurs in 10-20% of all infants with a birth weight of less than 1000 g. [1][2][3][4][5][6] Development of posthaemorrhagic hydrocephalus (PHHC) is seen in 5% of these patients. [4][5][6][7][8] The underlying pathogenesis of hydrocephalus following IVH is not well understood. However, a correlation of the amount of intraventricular blood with the development of PHHC has been proposed. 4 Local therapies after IVH in neonates, such as fibrinolysis, or steroid application failed to reduce the incidence of shunt dependent PHHC.9-14 From the results one may conclude that, apart from the occlusion of the arachnoid villi by blood clots, a fibroproliferative reaction is involved in the pathogenesis of PHHC. 15 16 Autopsy findings in adult patients with malresorptive hydrocephalus following aneurysmal subarachnoid haemorrhage (SAH) revealed a fibroproliferative reaction in conjunction with arachnoidal fibrosis. 15 It is hypothesised that this ultimately led to malresorption of CSF at the arachnoid villi. 15Local activation of collagen synthesis is suggested to be the major trigger for the fibroproliferative reaction.17 18 In experimental models of SAH, increased concentrations of procollagen propeptides of type I and III collagen in the CSF, and leptomeningeal deposition of collagen I and III have been found. [19][20][21] The fibre forming collagens (types I-III) are synthesised by mesenchymal cells as procollagens. The amount of type I procollagen released into the extracellular fluid is directly related to the amount of type I collagen fibres formed and deposited in the ...

show abstract

Posthemorrhagic hydrocephalus and brain injury in the preterm infant: Dilemmas in diagnosis and management

Cited by 38 publications

References 234 publications

CSF Removal in Infantile Posthemorrhagic Hydrocephalus Results in Significant Improvement in Cerebral Hemodynamics

CSF Removal in Infantile Posthemorrhagic Hydrocephalus Results in Significant Improvement in Cerebral Hemodynamics

Biomarkers in Neonatal Posthemorrhagic Hydrocephalus

Procollagen I C-propeptide in the cerebrospinal fluid of neonates with posthaemorrhagic hydrocephalus

Contact Info

Product

Resources

About