Long-term experience with subcutaneously tunneled external ventricular drainage in preterm infants

We previously reported on a series of 27 newborn infants treated for posthe morrhagic hydrocephalus with external ventricular drainage during 1984 to 1 989. In the present study we continued to evaluate this technique during th e subsequent 8 years (37 patients; mean birthweight 1251 +/- 478 g; mean ge stational age 29 +/- 2.9 weeks; 51 drains), and we now report on the long-t erm experience with this method, complications, and neurodevelopmental outc ome of the survivors. The mean age at drain insertion was 21 days, and the mean duration of drainage 23 days. Eight infants died of causes unrelated t o external ventricular drainage. Eleven of the survivors did not require a permanent shunt. Two patients experienced ventriculitis, resulting in an in fection rate of 5.4% per patient and 3.9% per drain. The neurodevelopmental outcome was mainly dependent on the extent of the pre-existing parenchymal injury. We conclude that external ventricular drainage is a safe and effec tive technique for the management of preterm infants with posthemorrhagic h ydrocephalus.