Ec. Benzel et al., THE TREATMENT OF HYDROCEPHALUS IN PRETERM INFANTS WITH INTRAVENTRICULAR HEMORRHAGE, Acta neurochirurgica, 122(3-4), 1993, pp. 200-203
The hospital charts and clinical course of forty-one patients requirin
g one or more ventricular drainage procedures for hydrocephalic compli
cations of neonatal intraventricular haemorrhage were evaluated retros
pectively. All drainage procedures were performed on patients with int
raventricular haemorrhage with ventricular dilatation (Grade III [25 p
atients]) and intraventricular and intraparenchymal haemorrhage (Grade
IV [16 patients]) who were medical management failures. Twenty-six ve
ntricular reservoirs (Rickham or McComb reservoirs) were placed in neo
nates weighing less than 1500 grams, allowing for a safe but intermitt
ent ventricular access. Eighteen of these reservoirs were subsequently
converted to ventriculoperitoneal shunts. Thirty-two percent of the p
atients incurred a shunt and/or reservoir infection and 59% required a
shunt revision during the first year of life. There was no mortality
related to the neurosurgical interventions. These results compare favo
rably with the published literature. No grade IV patients achieved a n
ormal functional level, while 10 grade III patients did. The incidence
of severe developmental delay (44% versus 28%) and death (38% versus
12%) was greater in the grade IV than the grade III patients.The place
ment of ventricular reservoirs is acceptable as an alternative to the
early placement of ventriculo-peritoneal shunts. This approach may red
uce the incidence of shunt infection as well as noninfectious shunt co
mplications.