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Intraventricular hemorrhage and posthemorrhagic hydrocephalus in preterm infants: diagnosis, classification, and treatment options

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Abstract

Purpose

Intraventricular hemorrhage is the most important adverse neurologic event for preterm and very low weight birth infants in the neonatal period. This pathology can lead to various delays in motor, language, and cognition development. The aim of this article is to give an overview of the knowledge in diagnosis, classification, and treatment options of this pathology.

Method

A systematic review has been made.

Results

The cranial ultrasound can be used to identify the hemorrhage and grade it according to the modified Papile grading system. There is no standardized protocol of intervention as there are controversial results on which of the temporizing neurosurgical procedures is best and about the appropriate parameters to consider a conversion to ventriculoperitoneal shunt. However, it has been established that the most important prognosis factor is the involvement and damage of the white matter.

Conclusion

More evidence is required to create a standardized protocol that can ensure the best possible outcome for these patients.

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Abbreviations

CBF:

Cerebral blood flow

CP:

Cerebral palsy

CSF:

Cerebrospinal fluid

DRIFT:

Drainage, irrigation, and fibrinolytic therapy

EVD:

External ventricular drainage

GM:

Germinal matrix

GMH:

Germinal matrix hemorrhage

IVH:

Intraventricular hemorrhage

LP:

Lumbar puncture

PHH:

Posthemorrhagic hydrocephalus

PVHI:

Periventricular hemorrhagic infarction

RT-US:

Real-time ultrasound

TNPs:

Temporizing neurosurgical procedures

VAD:

Ventricular access device

VLBW:

Very low birth weight

VP:

Ventriculoperitoneal

VSG:

Ventriculosubgaleal

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  1. Department of Clinical Sciences, Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Campus Guadalajara, Avenida General Ramón Corona 2514, Guadalajara, 45138, Mexico

    Paola Valdez Sandoval, Paola Hernández Rosales, Deyanira Gabriela Quiñones Hernández & Victor García Navarro

  2. Neonatology Department, Nuevo Hospital Civil de Guadalajara, Juan I. Menchaca, Guadalajara, 44340, Mexico

    Eva Alejandra Chavana Naranjo

  3. Neurosurgery Department, Nuevo Hospital Civil de Guadalajara, Juan I. Menchaca, Guadalajara, 44340, Mexico

    Victor García Navarro

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Valdez Sandoval, P., Hernández Rosales, P., Quiñones Hernández, D.G. et al. Intraventricular hemorrhage and posthemorrhagic hydrocephalus in preterm infants: diagnosis, classification, and treatment options. Childs Nerv Syst 35, 917–927 (2019). https://doi.org/10.1007/s00381-019-04127-x

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  • DOI: https://doi.org/10.1007/s00381-019-04127-x

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