Abstract
A frequent cause of hydrocephalus is the intraventricular hemorrhage (IVH) that is almost always related with prematurity. This condition is often the origin of important cognitive, motor, and behavioral sequels. IVH typically occurs during the first 3 days of postnatal life. Several clinical manifestations indicate its occurrence, although some hemorrhagic episodes can evolve with a clinically silent pattern. IVH can also present as a catastrophic event that calls for immediate attention. Ultrasonography (US) is the preferred tool used for its diagnosis and for follow-up evaluation. Given that the children’s outcomes depend on the extent of the hemorrhage and to the presence of associated parenchymal lesions, some grading systems for assessing the resulting brain damage have been developed, among them the Papile’s grading scale. Several medical, pharmacological, and surgical temporizing methods are used aimed at avoiding or delaying the eventual placement of a permanent CSF shunt.
At present, many authors manifest a reasonable reluctance to operate on small, preterm, infants, given the potential for well-known complications of CSF shunting. On the other hand, delaying definitive surgery in the presence of hydrocephalus might cause a progressive or even an irreversible brain damage. Recently, endoscopic procedures are being evaluated that show a success rate of approximately 30%, although CSF shunting remains as the most dependable surgical treatment. Morbidity and mortality of posthemorrhagic hydrocephalus (PHH) seems to be closely related to the severity and extension of the initial bleeding and to associated complications and comorbidities. Preventive measures for decreasing the risks for IVH are of utmost importance. In spite of advances in perinatal care, there exists a growing awareness of the need of improving research on prevention, on medical and/or surgical management, and on the rehabilitation and social integration of the affected individuals.
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Martínez-Lage, J.F., López-Guerrero, A.L., Almagro, MJ. (2017). Posthemorrhagic Hydrocephalus. In: Di Rocco, C., Pang, D., Rutka, J. (eds) Textbook of Pediatric Neurosurgery. Springer, Cham. https://doi.org/10.1007/978-3-319-31512-6_17-1
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DOI: https://doi.org/10.1007/978-3-319-31512-6_17-1
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Posthemorrhagic Hydrocephalus- Published:
- 02 August 2017
DOI: https://doi.org/10.1007/978-3-319-31512-6_17-2
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Posthemorrhagic Hydrocephalus- Published:
- 26 June 2017
DOI: https://doi.org/10.1007/978-3-319-31512-6_17-1