RANDOMIZED TRIAL OF EARLY CAPPING IN NEONATAL POSTHEMORRHAGIC VENTRICULAR DILATATION - RESULTS AT 30 MONTHS

One hundred and fifty seven infants with progressive ventricular dilat ation after intraventricular haemorrhage were randomised to either ear ly repeated cerebrospinal fluid tapping or conservative management. Th irty two (20%) infants died and 13 (8%) were lost to follow up. One hu ndred and twelve children (90% of survivors) were examined at 30 month s by a single experienced examiner. Overall, 54 (48%) scored less than 70 on the Griffiths developmental scales, 101 (90%) had neuromotor im pairment, and 85 (76%) had marked disability; 63 (56%) had multiple im pairments. Vision was severely affected in 10 (9%) and 30 (27%) had a field defect. Six per cent (seven children) had sensorineural hearing loss and 16 (14%) were taking regular anticonvulsant drugs. Although e arly cerebrospinal fluid tapping reduced the rate of ventricular and h ead expansion, there was no statistically significant difference (at t he 5% level) between the treatment groups in the prevalence of neuromo tor impairments, non-neuromtor impairments, nor multiple impairments a t 30 months. These findings were consistent regardless of the presence or absence of a parenchymal cerebral lesion at entry to the trial. In the Light of these findings and the 7% risk of cerebrospinal fluid in fection associated with repeated tapping, this form of early intervent ion cannot be recommended.