Developmental outcome following posthemorrhagic hydrocephalus in preterm infants. Comparison of twins discordant for hydrocephalus
S. L. Davis, W. H. Tooley and J. V. Hunt
Department of Pediatrics, University of California, Davis 95817.
The mental development and neurologic outcome of four sets of preterm
twins, in whom one infant within each pair developed posthemorrhagic
hydrocephalus during the neonatal period, were assessed. Each hydrocephalic
infant presented with signs of increased intracranial pressure and required
placement of a ventriculoperitoneal shunt. Three of the four hydrocephalic
infants required revision or replacement of the shunt during the first
year. The four nonhydrocephalic infants had normal neurologic outcomes. All
four hydrocephalic infants had some neurologic abnormalities on follow-up
examination. Neurologic abnormalities were transient in one infant and
persistent in three others, each of whom showed evidence of mild right
hemiparesis. Within each twin pair, developmental rates and mental test
scores were strikingly similar throughout infancy and early childhood. Two
of the twin pairs have undergone psychological assessments at 8 and 11
years of age. Relatively lower IQ scores were obtained for the
hydrocephalic child in each twin pair at these ages.
