Ventricular access device<i>versus</i>ventriculosubgaleal shunt in post hemorrhagic hydrocephalus associated with prematurity

Lam, Herman P.; Heilman, Carl B.

doi:10.3109/14767050903029576

Cited by 45 publications

(16 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our result is concordant with data in the literature [2, 17, 18] in which the PHH rate varies between 20 and 35%. Risk factors for PHH were high IVH grade and increased HC at diagnosis.…”

Section: Discussionsupporting

confidence: 93%

Post hemorrhagic hydrocephalus and neurodevelopmental outcomes in a context of neonatal intraventricular hemorrhage: an institutional experience in 122 preterm children

et al. 2018

View full text Add to dashboard Cite

BackgroundIntraventricular hemorrhage (IVH) is a frequent complication in extreme and very preterm births. Despite a high risk of death and impaired neurodevelopment, the precise prognosis of infants with IVH remains unclear. The objective of this study was to evaluate the rate and predictive factors of evolution to post hemorrhagic hydrocephalus (PHH) requiring a shunt, in newborns with IVH and to report their neurodevelopmental outcomes at 2 years of age.MethodsAmong all preterm newborns admitted to the department of neonatalogy at Rouen University Hospital, France between January 2000 and December 2013, 122 had an IVH and were included in the study. Newborns with grade 1 IVH according to the Papile classification were excluded.ResultsAt 2-year, 18% (n = 22) of our IVH cohort required permanent cerebro spinal fluid (CSF) derivation. High IVH grade, low gestational age at birth and increased head circumference were risk factors for PHH. The rate of death of IVH was 36.9% (n = 45). The rate of cerebral palsy was 55.9% (n = 43) in the 77 surviving patients (49.4%). Risk factors for impaired neurodevelopment were high grade IVH and increased head circumference.ConclusionHigh IVH grade was strongly correlated with death and neurodevelopmental outcome. The impact of an increased head circumference highlights the need for early management. CSF biomarkers and new medical treatments such as antenatal magnesium sulfate have emerged and could predict and improve the prognosis of these newborns with PHH.Electronic supplementary materialThe online version of this article (10.1186/s12887-018-1249-x) contains supplementary material, which is available to authorized users.

show abstract

“…Our result is concordant with data in the literature [2, 17, 18] in which the PHH rate varies between 20 and 35%. Risk factors for PHH were high IVH grade and increased HC at diagnosis.…”

Section: Discussionsupporting

confidence: 93%

Post hemorrhagic hydrocephalus and neurodevelopmental outcomes in a context of neonatal intraventricular hemorrhage: an institutional experience in 122 preterm children

et al. 2018

View full text Add to dashboard Cite

show abstract

“…There have been several retrospective reports from single institutions, and one from multiple institutions, that describe perioperative complications and the need for conversion to a permanent shunt. 54,57 A recent retrospective study reported the use of both devices at a single institution; the choice of device was based on the surgeon’s preference. 57 The mean age of the infants at the time of surgery was similar in the 2 treatment groups.…”

Section: Resultsmentioning

confidence: 99%

Neonatal posthemorrhagic hydrocephalus from prematurity: pathophysiology and current treatment concepts

Robinson

2012

PED

228

214

View full text Add to dashboard Cite

Object Preterm infants are at risk for perinatal complications, including germinal matrix–intraventricular hemorrhage (IVH) and subsequent posthemorrhagic hydrocephalus (PHH). This review summarizes the current understanding of the epidemiology, pathophysiology, management, and outcomes of IVH and PHH in preterm infants. Methods The MEDLINE database was systematically searched using terms related to IVH, PHH, and relevant neurosurgical procedures to identify publications in the English medical literature. To complement information from the systematic search, pertinent articles were selected from the references of articles identified in the initial search. Results This review summarizes the current knowledge regarding the epidemiology and pathophysiology of IVH and PHH, primarily using evidence-based studies. Advances in obstetrics and neonatology over the past few decades have contributed to a marked improvement in the survival of preterm infants, and neurological morbidity is also starting to decrease. The incidence of IVH is declining, and the incidence of PHH will likely follow. Currently, approximately 15% of preterm infants who suffer severe IVH will require permanent CSF diversion. The clinical presentation and surgical management of symptomatic PHH with temporary ventricular reservoirs (ventricular access devices) and ventriculosubgaleal shunts and permanent ventriculoperitoneal shunts are discussed. Preterm infants who develop PHH that requires surgical treatment remain at high risk for other related neurological problems, including cerebral palsy, epilepsy, and cognitive and behavioral delay. This review highlights numerous opportunities for further study to improve the care of these children. Conclusions A better grasp of the pathophysiology of IVH is beginning to impact the incidence of IVH and PHH. Neonatologists conduct rigorous Class I and II studies to advance the outcomes of preterm infants. The need for well-designed multicenter trials is essential because of the declining incidence of IVH and PHH, variations in referral patterns, and neonatal ICU and neurosurgical management. Well-designed multicenter trials will eventually produce evidence to enable neurosurgeons to provide their smallest, most vulnerable patients with the best practices to minimize perioperative complications and permanent shunt dependence, and most importantly, optimize long-term neurodevelopmental outcomes.

show abstract

“…VSGSs are often appealing because they obviate the need for placing hardware that is notorious for its infection risk. Many groups have identified complications with this procedure [4,20,21,22,23]. Limbrick et al [4] looked at a series of 325 Papile grade III and IV premature infants and found 95 who required a temporizing procedure.…”

Section: Discussionmentioning

confidence: 99%

“…Lam and Heilman [23] specifically compared their series of 32 preterm infants with IVH and divided them into two groups, one treated with VAD and one with VSGS. In this small series, patients treated with a VSGS had similar rates of avoiding placement of a permanent shunt (28.57%) while VAD patients were more frequently shunted (only 6.25% avoiding shunt placement).…”

Section: Discussionmentioning

confidence: 99%

Ventricular Access Devices Are Safe and Effective in the Treatment of Posthemorrhagic Ventricular Dilatation prior to Shunt Placement

et al. 2012

View full text Add to dashboard Cite

Intraventricular hemorrhage of prematurity (IVH) is a diagnosis that has become more frequent in recent years. Advances in medical care have led to survival of increasingly premature infants, as well as infants with more complex medical conditions. Treatment with a ventricular access device (VAD) was reported almost 3 decades ago; however, it is unclear how effective this treatment is in the current population of premature infants. At our institution (from 2004 to present), we treat posthemorrhagic hydrocephalus (PHH) with a VAD. In order to look at safety and efficacy, we retrospectively combed the medical records of premature children, admitted to Lucile Packard Children’s Hospital from January 2005 to December 2009, and identified 310 premature children with IVH. Of these, 28 children required treatment for PHH with a VAD. There were no infections associated with placement of these devices and a very low rate of other complications, such as need for repositioning (7.41%) or replacement (3.75%). Our data show that treatment with a VAD is very safe, with few complications and can be used to treat PHH in this very complex infant population.

show abstract

Ventricular access deviceversusventriculosubgaleal shunt in post hemorrhagic hydrocephalus associated with prematurity

Abstract: VSGS is an effective means of providing temporary continuous drainage of CSF in PHH with an acceptable complication rate. VSGS has many advantages that make it superior to VAD as a temporizing shunt.

Cited by 45 publications

References 10 publications

Post hemorrhagic hydrocephalus and neurodevelopmental outcomes in a context of neonatal intraventricular hemorrhage: an institutional experience in 122 preterm children

Post hemorrhagic hydrocephalus and neurodevelopmental outcomes in a context of neonatal intraventricular hemorrhage: an institutional experience in 122 preterm children

Neonatal posthemorrhagic hydrocephalus from prematurity: pathophysiology and current treatment concepts

Ventricular Access Devices Are Safe and Effective in the Treatment of Posthemorrhagic Ventricular Dilatation prior to Shunt Placement

Contact Info

Product

Resources

About