USE OF EXTERNAL DRAINAGE FOR POSTHEMORRHAGIC HYDROCEPHALUS IN VERY-LOW-BIRTH-WEIGHT PREMATURE-INFANTS

To treat progressive posthemorrhagic hydrocephalus we used early exter nal ventricular drainage (EVD) in 14 premature infants. We think it is important that the catheters in these critically ill infants be inser ted in the neonatal intensive care unit, allowing us to keep the infan ts in an extremely stable environment. Only after prolonged external v entricular drainage (on average 38.4 days) is a ventriculoperitoneal s hunt considered, preferably when the child has reached a body weight o f 2000 g. There were no infections or other severe drainage-related pr oblems. We report mean daily EVD volumes (which are related to body we ight) and EVD duration. The 14 patients included 9 who required perman ent shunting. Comparing the mortality, morbidity and follow-up data to at least 3 months of age in this group with similar data for an earli er cohort treated with lumbar punctures and late permanent shunting, w e demonstrate the safety of the policy we have recently adopted.