scholarly journals Repeated tapping of ventricular reservoir in preterm infants with post-hemorrhagic ventricular dilatation does not increase the risk of reservoir infection

2009 ◽  
Vol 30 (3) ◽  
pp. 218-221 ◽  
Author(s):  
K Kormanik ◽  
J Praca ◽  
H J L Garton ◽  
S Sarkar
Keyword(s):  
Preterm Infants ◽  
Ventricular Dilatation ◽  
Ventricular Reservoir

Ventricular dilatation in preterm infants

1993 ◽  
Vol 9 (6) ◽  
pp. 498
Author(s):  
Alan Leviton ◽  
Karl Kuban
Keyword(s):  
Preterm Infants ◽  
Ventricular Dilatation

scholarly journals Posthemorrhagic ventricular dilatation in preterm infants

Neurology ◽  
2018 ◽  
Vol 90 (8) ◽  
pp. e698-e706 ◽  
Author(s):  
Lara M. Leijser ◽  
Steven P. Miller ◽  
Gerda van Wezel-Meijler ◽  
Annemieke J. Brouwer ◽  
Jeffrey Traubici ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Ventricular Dilatation ◽  
Cranial Ultrasound ◽  
Class Iii ◽  
Neurodevelopmental Outcomes ◽  
Initial Intervention ◽  
Postmenstrual Age ◽  
Observational Cohort ◽  
Potential Risks ◽  
Clinical Measures

ObjectiveTo compare neurodevelopmental outcomes of preterm infants with and without intervention for posthemorrhagic ventricular dilatation (PHVD) managed with an “early approach” (EA), based on ventricular measurements exceeding normal (ventricular index [VI] <+2 SD/anterior horn width <6 mm) with initial temporizing procedures, followed, if needed, by permanent shunt placement, and a “late approach” (LA), based on signs of increased intracranial pressure with mostly immediate permanent intervention.MethodsObservational cohort study of 127 preterm infants (gestation <30 weeks) with PHVD managed with EA (n = 78) or LA (n = 49). Ventricular size was measured on cranial ultrasound. Outcome was assessed at 18–24 months.ResultsForty-nine of 78 (63%) EA and 24 of 49 (49%) LA infants received intervention. LA infants were slightly younger at birth, but did not differ from EA infants for other clinical measures. Initial intervention in the EA group occurred at younger age (29.4/33.1 week postmenstrual age; p < 0.001) with smaller ventricles (VI 2.4/14 mm >+2 SD; p < 0.01), and consisted predominantly of lumbar punctures or reservoir taps. Maximum VI in infants with/without intervention was similar in EA (3/1.5 mm >+2 SD; p = 0.3) but differed in the LA group (14/2.1 mm >+2 SD; p < 0.001). Shunt rate (20/92%; p < 0.001) and complications were lower in EA than LA group. Most EA infants had normal outcomes (>−1 SD), despite intervention. LA infants with intervention had poorer outcomes than those without (p < 0.003), with scores <−2 SD in 81%.ConclusionIn preterm infants with PHVD, those with early intervention, even when eventually requiring a shunt, had outcomes indistinguishable from those without intervention, all being within the normal range. In contrast, in infants managed with LA, need for intervention predicted worse outcomes. Benefits of EA appear to outweigh potential risks.Classification of evidenceThis study provides Class III evidence that for preterm infants with PHVD, an EA to management results in better neurodevelopmental outcomes than a LA.

Decompressing posthaemorrhagic ventricular dilatation significantly improves regional cerebral oxygen saturation in preterm infants

2015 ◽  
Vol 104 (7) ◽  
pp. 663-669 ◽  
Author(s):  
F Norooz ◽  
B Urlesberger ◽  
V Giordano ◽  
K Klebermasz-Schrehof ◽  
M Weninger ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Preterm Infants ◽  
Cerebral Oxygen Saturation ◽  
Ventricular Dilatation ◽  
Cerebral Oxygen ◽  
Regional Cerebral Oxygen Saturation

Treatment of post-haemorrhage ventricular dilatation with an Ommaya's reservoir: management and outcome of 64 preterm infants

2001 ◽  
Vol 17 (6) ◽  
pp. 334-340 ◽  
Author(s):  
Richard E. ◽  
Cinalli G. ◽  
Assis D. ◽  
Pierre-Kahn A. ◽  
Lacaze-Masmonteil T.
Keyword(s):  
Preterm Infants ◽  
Reservoir Management ◽  
Ventricular Dilatation

Ventricular reservoir versus ventriculosubgaleal shunt for posthemorrhagic hydrocephalus in preterm infants: infection risks and ventriculoperitoneal shunt rate

2014 ◽  
Vol 14 (5) ◽  
pp. 447-454 ◽  
Author(s):  
Joanna Y. Wang ◽  
Anubhav G. Amin ◽  
George I. Jallo ◽  
Edward S. Ahn
Keyword(s):  
Preterm Infants ◽  
Time Interval ◽  
Neurodevelopmental Outcomes ◽  
Shunt Insertion ◽  
Posthemorrhagic Hydrocephalus ◽  
Vp Shunt ◽  
Shunt Placement ◽  
Device Infection ◽  
Ventriculosubgaleal Shunt ◽  
Ventricular Reservoir

Object The most common neurosurgical condition observed in preterm infants is intraventricular hemorrhage (IVH), which often results in posthemorrhagic hydrocephalus (PHH). These conditions portend an unfavorable prognosis; therefore, the potential for poor neurodevelopmental outcomes necessitates a better understanding of the comparative effectiveness of 2 temporary devices commonly used before the permanent insertion of a ventriculoperitoneal (VP) shunt: the ventricular reservoir and the ventriculosubgaleal shunt (VSGS). Methods The authors analyzed retrospectively collected information for 90 patients with IVH and PHH who were treated with insertion of a ventricular reservoir (n = 44) or VSGS (n = 46) at their institution over a 14-year period. Results The mean gestational age and weight at device insertion were lower for VSGS patients (30.1 ± 1.9 weeks, 1.12 ± 0.31 kg) than for reservoir patients (31.8 ± 2.9 weeks, 1.33 ± 0.37 kg; p = 0.002 and p = 0.004, respectively). Ventricular reservoir insertion was predictive of more CSF taps prior to VP shunt placement compared with VSGS placement (10 ± 8.7 taps vs 1.6 ± 1.7 taps, p < 0.001). VSGS patients experienced a longer time interval prior to VP shunt placement than reservoir patients (80.8 ± 67.5 days vs 48.8 ± 26.4 days, p = 0.012), which corresponded to VSGS patients gaining more weight by the time of shunt placement than reservoir patients (3.31 ± 2.0 kg vs 2.42 ± 0.63 kg, p = 0.016). Reservoir patients demonstrated a trend toward more positive CSF cultures compared with VSGS patients (n = 9 [20.5%] vs n = 5 [10.9%], p = 0.21). There were no significant differences in the rates of overt device infection requiring removal (reservoir, 6.8%; VSGS, 6.5%), VP shunt insertion (reservoir, 77.3%; VSGS, 76.1%), or early VP shunt infection (reservoir, 11.4%; VSGS, 13.0%) between the 2 cohorts. Conclusions Although the rates of VP shunt requirement and device infection were similar between patients treated with the reservoir versus the VSGS, VSGS patients were significantly older and had achieved greater weights at the time of VP shunt insertion. The authors' results suggest that the VSGS requires less labor-intensive management by ventricular tapping; the VSGS patients also attained higher weights and more optimal surgical candidacy at the time of VP shunt insertion. The potential differences in long-term developmental and neurological outcomes between VSGS and reservoir placement warrant further study.

Impaired brain growth and neurodevelopment in preterm infants with posthaemorrhagic ventricular dilatation

2012 ◽  
Vol 101 (7) ◽  
pp. 743-748 ◽  
Author(s):  
Sally Jary ◽  
Agnese De Carli ◽  
Luca A Ramenghi ◽  
Andrew Whitelaw
Keyword(s):  
Preterm Infants ◽  
Ventricular Dilatation ◽  
Brain Growth

Developmental Outcome of Very Low Birth Weight Infants with Intraventricular Hemorrhage

1993 ◽  
Vol 77 (3) ◽  
pp. 894-894 ◽  
Author(s):  
Anna J. Whitehead
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Intraventricular Hemorrhage ◽  
Poor Prognosis ◽  
Very Low Birth Weight ◽  
Ventricular Dilatation ◽  
Developmental Outcome ◽  
Low Birth Weight Infants

Analyses of data from 20 infants confirmed that ventricular dilatation in VLBW preterm infants carries poor prognosis for development, but not IVH alone.

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