Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Child's Nervous System
Published in: Child's Nervous System 11/2010

Open Access 01-11-2010 | Original Paper

Ventriculosubgaleal shunt procedure and its long-term outcomes in premature infants with post-hemorrhagic hydrocephalus

Authors: Vaner Köksal, Suat Öktem

Published in: Child's Nervous System | Issue 11/2010

Login to get access

Abstract

Objective

It is well known that 10–15% of hydrocephalus cases at childhood and 40–50% in premature infants, occur following Germinal matrix hemorrhage (GMH). Such hemorrhages are reported to arise due to the rupture of germinal matrix (GM) vessels as a result of cerebral blod flow changes among infants with <1500 g birth weight and <32 weeks old. Intraventricular hemorrhage (IVH) associated with GMH leads to a disruption in the cerebrospinal fluid (CSF) and ventricular dilatation. Ventriculosubgaleal shunt (VSGS) is preferred in those hydrocephalus cases because it is a simple and rapid method, precludes the need for repetitive aspiration for evacuation of CSF, establishes a permanent decompression without causing electrolyte and nutritional losses, and aims to protect the cerebral development of newborns with GMH.

Material and method

The present study comprises 25 premature cases, subjected to VSGS and diagnosed with post-hemorrhagic hydrocephalus (PHH) arising from IVH associated with GM, and low birth weight (LBW) in the Neurosurgery Department of the Medical Faculty of Erciyes University between July 2002 and September 2006. VSGS surgery was performed on those cases, and their clinical and radiological prognoses were monitored with regard to several parameters.

Results

Mortality and morbidity results were found to be lower than those in PPH treatment methods. While prognosis of grade 4 GMHs was poor, grades 2 and 3 GMHs displayed a much better prognosis after VSGS along with complete recovery in some hydrocephalus cases.
Literature
1.
Papile LA, Burstein J, Burstein R, Koffler H (1978) Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. J Pediatr 92(4):529–534CrossRefPubMed
2.
Reinprecht A, Dietrich W, Berger A, Bavinzski G, Weninger M, Czech T (2001) Posthemorrhagic hydrocephalus in preterm infants: long-term follow-up and shunt-related complications. Child’s Nerv Syst 17:663–669CrossRef
3.
Kazan S, Güra A, Uçar T, Korkmaz E, Ongun H, Akyuz M (2005) Hydrocephalus after intraventricular hemorrhage in preterm and low-birth weight infants: analysis of associated risk factors for ventriculoperitoneal shunting. Surg Neurol 64:S2:77–S2:81CrossRef
4.
Horinek D, Cihar M, Tichy M (2003) Current methods in the treatment of posthemorrhagic hydrocephalus in infants. Bratisl Lek Listy 104(11):347–351PubMed
5.
6.
Hudgins RJ, Boydston WR, Gilreath CL (1998) Treatment of posthemorrhagic hydrocephalus in the preterm infant with a ventricular access device. Pediatr Neurosurg 29:309–313CrossRefPubMed
7.
Kadri H, Mawla AA, Kazah J (2006) The incidence, timing, and predisposing factors of germinal matrix and intraventricular hemorrhage (GMH/IVH) in preterm neonates. Childs Nerv Syst 22:1086–1090CrossRefPubMed
8.
9.
Willis BK, Kumar CR, Wylen EL, Nanda A (2005) Ventriculosubgaleal shunts for posthemorrhagic hydrocephalus in premature ınfants. Pediatr Neurosurg 41:178–185CrossRefPubMed
10.
Mc Cullough D (1985) Hydrocephalus: treatment. In: Rengachary S, Wilkins R (eds) Neurosurgery, pp 2140–2150
11.
Taylor AG, Peter JC (2001) Advantages of delayed VP shunting in post-haemorrhagic hydrocephalus seen in low-birth-weight infants. Child’s Nerv Syst 17:328–333CrossRef
12.
Roland EH, Hill A (1997) Intraventricular hemorrhage and posthemorrhagic hydrocephalus. Current and potential future interventions. Clin Perinatol 24:589–605PubMed
13.
Levy ML, Masri MS, McComb JG (1997) Outcome for preterm infants with germinal matrix hemorrhage and progressive hydrocephalus. Neurosurgery 41:1111–1118CrossRefPubMed
14.
Lin JP, Goh W, Brown JK, Steers AJW (1992) Neurological outcome following neonatal post-haemorrhagic hydrocephalus: the effects of maximum raised intracranial pressure and ventriculo-peritoneal shunting. Child’s Nerv Syst 8:190–197CrossRef
15.
McCallum J, Turbeville D (1994) Cost and outcome in a series of shunted premature infants with intraventricular hemorrhage. Pediatr Neurol (1992) 20:63–67
16.
Scarff TB, Anderson DE, Anderson CL (1992) Caldwell CC (1983) Complications of ventriculo-peritoneal shunts in premature infants. Concepts Pediatr Neurosurg 4:81–89
17.
Tubbs RS, Smyth MD, Wellons JC, Blount JP, Grabb PA, Oakes WJ (2003) Life expectancy of ventriculosubgaleal shunt revisions. Pediatr Neurosurg 38:244–246CrossRefPubMed
18.
Sklar F, Adegbite A, Shapiro K, Miller K (1992) Ventriculosubgaleal shunts: management of posthemorrhagic hydrocephalus in premature infants. Pediatr Neurosurg 18:263–265CrossRefPubMed
19.
Rahman S, Teo C, Morris W, Lao D, Boop FA (1995) Ventriculosubgaleal shunt: a treatment option for progressive posthemorrhagic hydrocephalus. Childs Nerv Syst 11:650–654CrossRefPubMed
20.
Vinchon M, Lapeyre F, Duquennoy C, Dhellemmes P (2001) Early treatment of posthemorrhagic hydrocephalus in low-birth-weight infants with valveless ventriculoperitoneal shunts. Pediatr Neurosurg 35:299–304CrossRefPubMed
21.
Bruinsma N, Stobberingh EE, Herpers MJ, Vles JS, Weber BJ, Gavilanes DA (2000) Subcutaneous ventricular catheter reservoir and ventriculoperitoneal drain-related infections in preterm infants and young children. Clin Microbiol Infect 6:202–206CrossRefPubMed
22.
Kim DK, Uttley D, Bell BA, Marsh HT, Moore AJ (1995) Comparison of rates of infection of two methods of emergency ventricular drainage. J Neurol Neurosurg Psychiatry 58:444–446CrossRefPubMed
23.
Richard E, Cinalli G, Assis D, Pierre-Kahn A, Lacaze-Masmonteil T (2001) Treatment of post-haemorrhage ventricular dilatation with an Ommaya’s reservoir: management and outcome of 64 preterm infants. Child’s Nerv Syst 17:334–340CrossRef
24.
Steinbok P, Cochrane DD (1994) Ventriculosubgaleal shunt in the management of recurrent ventriculoperitoneal shunt infection. Childs Nerv Syst 10:536–539CrossRefPubMed
25.
Linder N, Haksin O, Levit O, Klinger G, Prince T (2003) Risk factors for intraventricular hemorrhage in very low birth weight premature ınfants: a retrospective case-control study. Pediatrics 111:590–595CrossRef
26.
Gurtner P, Bass T, Gudeman S, Penix J, Philput C, Schinco F (1992) Surgical management of posthemorrhagic hydrocephalus in 22 low-birth-weight infants. Childs Nerv Syst 8:198–202CrossRefPubMed
27.
Murphy BP, Inder TE, Rooks V, Taylor GA, Anderson NJ, Mogridge N et al (2002) Posthemorrhagic ventricular dilatation in the premature infant: natural history and predictors of outcome. Arch Dis Child Fetal Neonatal Ed 87:37–41CrossRef
28.
Tortorolo G, Luciano R, Papacci P, Tonelli T (1999) Intraventricular hemorrhage: past, present and future, focusing on classification, pathogenesis and prevention. Child’s Nerv Syst 15:652–661CrossRef
29.
Ventriculomegaly Trial Group (1990) Randomised trial of early tapping in neonatal posthemorrhagic ventricular dilatation. Arch Dis Child 65:3–10CrossRef
30.
Cornips E, Van Calenbergh F, Plets C, Devlieger H, Casaer P (1997) Use of external drainage for posthemorrhagic hydrocephalus in very low birth weight premature infants. Child’s Nerv Syst 13:369–374CrossRef
31.
Rhodes TT, Edwards WH, Saunders RL, Harbaugh RE, Little CL, Sargent SK (1987) External ventricular drainage for initial treatment of neonatal posthemorrhagic hydrocephalus: surgical and neurodevelopmental outcome. Pediatr Neurosci 13:255–262CrossRefPubMed
32.
Robertson CM, Svenson LW, Joffres MR (1998) Prevalence of cerebral palsy in Alberta. Can J Neurol Sci 25:117–22PubMed
33.
De Vries LS, Rademaker KJ, Groenendaal F, Eken P, van Haastert IC, Vandertop WP, Gooskens R, Meiners LC (1998) Correlation between neonatal cranial ultrasound, MRI in infancy and neurodevelopmental outcome in infants with a large intraventricular haemorrhage with or without unilateral parenchymal involvement. Neuropediatrics 29(4):180–188CrossRefPubMed
34.
Hamrick SE, Miller SP, Leonard C, Glidden DV, Goldstein R, Ramaswamy V, Piecuch R, Ferriero DM (2004) Trends in severe brain injury and neurodevelopmental outcome in premature newborn infants: the role of cystic periventricular leukomalacia. J Pediatr 145(5):593–599CrossRefPubMed
35.
Pomerance JJ, Richardson J (1993) Neonatology for the clinician, 1st edn. Applenton & Lange, Norwalk, pp 425–435
Metadata
Title
Ventriculosubgaleal shunt procedure and its long-term outcomes in premature infants with post-hemorrhagic hydrocephalus
Authors
Vaner Köksal
Suat Öktem
Publication date
01-11-2010
Publisher
Springer-Verlag
Published in
Child's Nervous System / Issue 11/2010
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-010-1118-x

Other articles of this Issue 11/2010

Child's Nervous System 11/2010 Go to the issue

Original Paper

Occipital expansion without osteotomies in Apert syndrome

Case Report

Mapping of the cortical spinal tracts using magnetoencephalography and diffusion tensor tractography in pediatric brain tumor patients

Original Paper

Initial predictive factors of outcome in severe non-accidental head trauma in children

Original Paper

Posterior fossa tumors in children with neurofibromatosis type 1 (NF1)

Letter to the Editor

Reply to Dr H Gardner

Original Paper

Study of brain growth in children—a new approach to volume measurements using MRI-reconstructed 3D neuroimaging