Treatment of intraventricular hemorrhage in infants
Keywords:intraventricular hemorrhage, germinal matrix, posthemorrhagic hydrocephalus, neuroendoscopic lavage
Intraventricular hemorrhage (IVH) is a disorder of the central nervous system, which is most frequently diagnosed in newborns. The disorder occurrence and development are related to the gestation age and weight of a newborn. IVH arises in 30 % of newborns with weight under 1500 g and develops on the 2nd — 3rd day after birth. Fifty-five percent of newborns present a neurological deficit following IVH, 30 % of patients with IVH have a permanent disability in early childhood and 70 % — at a different age. Premature newborns with IVH of III–IV grade have a high risk of developing posthemorrhagic hydrocephalus (PHH), cerebral palsy and mental disturbances. Literature review and analysis of the world major medical databases (MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, PubMed) of etiology, pathogenesis, treatment of IVH in infants illustrate advantages and limitations of the various methods for the control of intracranial hypertension associated with IVH and PHH. Gold standard and method of permanent control of intracranial hypertension — ventriculoperitoneal shunting frequently requires temporary control of the intracranial pressure and has limitations in this category of patients. Considering that there is no the only correct way of treatment of IVH and PHH, and recognizing disadvantages for each method of temporary and permanent draining of the CSF, the interventions should focus on the early clearing of the CSF pathways. Among proposed techniques, neuroendoscopic lavage is worthy of special attention, because it is associated with a lower rate of infectious complications and need in subsequent neurosurgical interventions according to the research results. Considering the pathogenesis of PHH development and treatment results, techniques of neuroendoscopic lavage need to be further researched and implemented in the list of neurosurgical procedures for the children with IVH in Ukraine.
1. Buonocore G, Bracci R, Weindling M, editors. Neonatology. Springer Milan; 2012; [CrossRef]
2. Murphy BP, Inder TE, Rooks V, Taylor GA, Anderson NJ, Mogridge N, Horwood LJ, Volpe JJ. Posthaemorrhagic ventricular dilatation in the premature infant: natural history and predictors of outcome. Arch Dis Child Fetal Neonatal Ed. 2002 Jul;87(1):F37-41. [CrossRef] [PubMed] [PubMed Central]
3. Barashnev YI. Perinatal neurology. Moscow: Triada-X; 2001. Russian.
4. Semenkov OG, Iova AS, Lebedko AM, Rozner GO. Comprehensive treatment of severe intraventricular hemorrhage in newborns. Pediatrics. 2008;87(1): 44-48. Russian.
5. Shabalov NP. Neonatology. Moscow: MEDpress-inform; 2006. Russian.
6. Orlov YA, Kasyanov VA. The differentiated treatment of perinatal intracranial hemorrhages at newborns. Ukr Neurosurg J. 2008;(1):50-53. Russian. [CrossRef]
7. Gerus SV, Orlov YA, Marushchenko LL, Protsenko IP, Shchirov VN. Peculiarities of intracranial hemorrhages clinical course during perinatal period in premature newborns. Coliection of scientific works of staff member of P. L. Shupyk NMAPE. 2013;22(1):104-112. Russian.
8. Shooman D, Portess H, Sparrow O. A review of the current treatment methods for posthaemorrhagic hydrocephalus of infants. Cerebrospinal Fluid Res. 2009 Jan 30;6:1. [CrossRef] [PubMed] [PubMed Central]
9. Vespa PM, McArthur D, O’Phelan K, Glenn T, Etchepare M, Kelly D, Bergsneider M, Martin NA, Hovda DA. Persistently low extracellular glucose correlates with poor outcome 6 months after human traumatic brain injury despite a lack of increased lactate: a microdialysis study. J Cereb Blood Flow Metab. 2003 Jul;23(7):865-77. [CrossRef] [PubMed]
10. Ballabh P, Braun A, Nedergaard M. Anatomic analysis of blood vessels in germinal matrix, cerebral cortex, and white matter in developing infants. Pediatr Res. 2004 Jul;56(1):117-24. [CrossRef] [PubMed]
12. Synnes AR, Macnab YC, Qiu Z, Ohlsson A, Gustafson P, Dean CB, Lee SK; Canadian Neonatal Network. Neonatal intensive care unit characteristics affect the incidence of severe intraventricular hemorrhage. Med Care. 2006 Aug;44(8):754-9. [CrossRef] [PubMed]
13. Pontello D, Ianni A, Driul L, Della Martina M, Veronese P, Chiandotto V, Furlan R, Macagno F, Marchesoni D. Prenatal risk factors for intraventricular hemorrhage, neonatal death and impaired psychomotor development in very low birth weight infants. Minerva Ginecol. 2008 Jun;60(3):223-9. [PubMed]
15. Soul JS, Eichenwald E, Walter G, Volpe JJ, du Plessis AJ. CSF removal in infantile posthemorrhagic hydrocephalus results in significant improvement in cerebral hemodynamics. Pediatr Res. 2004 May;55(5):872-6. [CrossRef] [PubMed]
16. Volpe J.J. Intracranial hemorrhage: germinal matrix-intraventricular hemorrhage. In Volpe JJ, ed. Neurology of the Newborn. 5th edition. Philadelphia, Saunders Elsevier; 2008: 517-288.
18. de Vries LS, Liem KD, van Dijk K, Smit BJ, Sie L, Rademaker KJ, Gavilanes AW; Dutch Working Group of Neonatal Neurology. Early versus late treatment of posthaemorrhagic ventricular dilatation: results of a retrospective study from five neonatal intensive care units in The Netherlands. Acta Paediatr. 2002;91(2):212-7. [CrossRef] [PubMed]
20. Hudgins RJ, Boydston WR, Gilreath CL. Treatment of posthemorrhagic hydrocephalus in the preterm infant with a ventricular access device. Pediatr Neurosurg. 1998 Dec;29(6):309-13. [CrossRef] [PubMed]
22. International randomised controlled trial of acetazolamide and furosemide in posthaemorrhagic ventricular dilatation in infancy. International PHVD Drug Trial Group. Lancet. 1998 Aug 8;352(9126):433-40. [CrossRef] [PubMed]
25. Maertzdorf WJ, Vles JS, Beuls E, Mulder AL, Blanco CE. Intracranial pressure and cerebral blood flow velocity in preterm infants with posthaemorrhagic ventricular dilatation. Arch Dis Child Fetal Neonatal Ed. 2002 Nov;87(3):F185-8. [CrossRef] [PubMed] [PubMed Central]
27. Whitelaw A. Repeated lumbar or ventricular punctures in newborns with intraventricular hemorrhage. Cochrane Database Syst Rev. 2001;(1):CD000216. Update in: Cochrane Database Syst Rev. 2017 Apr 06;4:CD000216. [CrossRef] [PubMed]
28. Luciano R, Velardi F, Romagnoli C, Papacci P, De Stefano V, Tortorolo G. Failure of fibrinolytic endoventricular treatment to prevent neonatal post-haemorrhagic hydrocephalus. A case-control trial. Childs Nerv Syst. 1997 Feb;13(2):73-6. [CrossRef] [PubMed]
29. Yapicioğlu H, Narli N, Satar M, Soyupak S, Altunbaşak S. Intraventricular streptokinase for the treatment of posthaemorrhagic hydrocephalus of preterm. J Clin Neurosci. 2003 May;10(3):297-9. [CrossRef] [PubMed]
30. Gurtner P, Bass T, Gudeman SK, Penix JO, Philput CB, Schinco FP. Surgical management of posthemorrhagic hydrocephalus in 22 low-birth-weight infants. Childs Nerv Syst. 1992 Jun;8(4):198-202. [CrossRef] [PubMed]
31. Cornips E, Van Calenbergh F, Plets C, Devlieger H, Casaer P. Use of external drainage for posthemorrhagic hydrocephalus in very low birth weight premature infants. Childs Nerv Syst. 1997 Jul;13(7):369-74. [CrossRef] [PubMed]
32. Berger A, Weninger M, Reinprecht A, Haschke N, Kohlhauser C, Pollak A. Long-term experience with subcutaneously tunneled external ventricular drainage in preterm infants. Childs Nerv Syst. 2000 Feb;16(2):103-9; discussion 110. [CrossRef] [PubMed]
33. Rhodes TT, Edwards WH, Saunders RL, Harbaugh RE, Little CL, Morgan LJ, Sargent SK. External ventricular drainage for initial treatment of neonatal posthemorrhagic hydrocephalus: surgical and neurodevelopmental outcome. Pediatr Neurosci. 1987;13(5):255-62. [CrossRef] [PubMed]
34. Reinprecht A, Dietrich W, Berger A, Bavinzski G, Weninger M, Czech T. Posthemorrhagic hydrocephalus in preterm infants: long-term follow-up and shunt-related complications. Childs Nerv Syst. 2001 Nov;17(11):663-9. [CrossRef] [PubMed]
35. Weninger M, Salzer HR, Pollak A, Rosenkranz M, Vorkapic P, Korn A, Lesigang C. External ventricular drainage for treatment of rapidly progressive posthemorrhagic hydrocephalus. Neurosurgery. 1992 Jul;31(1):52-7; discussion 57-8. [CrossRef] [PubMed]
36. Volpe JJ. Neurology of the newborn. 5th Edition. Philadelphia: Saunders; 2008.
38. Fountain DM, Chari A, Allen D, James G. Comparison of the use of ventricular access devices and ventriculosubgaleal shunts in posthaemorrhagic hydrocephalus: systematic review and meta-analysis. Childs Nerv Syst. 2016 Feb;32(2):259-67. [CrossRef] [PubMed] [PubMed Central]
39. Heep A, Engelskirchen R, Holschneider A, Groneck P. Primary intervention for posthemorrhagic hydrocephalus in very low birthweight infants by ventriculostomy. Childs Nerv Syst. 2001 Jan;17(1-2):47-51. [CrossRef] [PubMed]
40. Paraicz E, Kónya, Bognár M, Balla Z. On early surgery of hydrocephalus in low-birth-weight infants. Zentralbl Neurochir. 1992;53(1):20-4. [PubMed]
41. Pulido-Rivas P, Martínez-Sarries FJ, Ochoa M, Sola RG. [Treatment of hydrocephalus secondary to intraventricular haemorrhage in preterm infants. A review of the literature]. Rev Neurol. 2007 May 16-31;44(10):616-24. Spanish. [PubMed]
45. Whitelaw A, Evans D, Carter M, Thoresen M, Wroblewska J, Mandera M, Swietlinski J, Simpson J, Hajivassiliou C, Hunt LP, Pople I. Randomized clinical trial of prevention of hydrocephalus after intraventricular hemorrhage in preterm infants: brain-washing versus tapping fluid. Pediatrics. 2007 May;119(5):e1071-8. [CrossRef] [PubMed]
46. Schulz M, Bührer C, Pohl-Schickinger A, Haberl H, Thomale UW. Neuroendoscopic lavage for the treatment of intraventricular hemorrhage and hydrocephalus in neonates. J Neurosurg Pediatr. 2014 Jun;13(6):626-35. [CrossRef] [PubMed]
47. Etus V, Kahilogullari G, Karabagli H, Unlu A. Early Endoscopic Ventricular Irrigation for the Treatment of Neonatal Posthemorrhagic Hydrocephalus: A Feasible Treatment Option or Not? A Multicenter Study. Turk Neurosurg. 2018;28(1):137-141. [CrossRef] [PubMed]
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