Posthemorrhagic hydrocephalus. Use of an intravenous-type catheter for cerebrospinal fluid drainage
P. J. Marro, D. A. Dransfield, S. H. Mott and W. C. Allan
Department of Pediatrics, Maine Medical Center, Portland.
STUDY OBJECTIVE: To report a 9-year experience with the treatment of
posthemorrhagic hydrocephalus (PHH) with the use of an easily inserted
external ventricular drain. DESIGN: A case series with a retrospective
review of hospital records and cranial ultrasound results, from 1981
through 1989, in all infants with PHH. INTERVENTION: A previously defined
method of identification and bedside management of PHH was applied. If
infants reached 2 kg of body weight and PHH recurred, a
ventriculoperitoneal shunt was inserted. RESULTS: A total of 70 procedures
were performed in 24 patients, and all were associated with a decrease in
head circumference and ventricular size on ultrasound scan. One infection
occurred, and only 12 infants required a ventriculoperitoneal shunt.
CONCLUSIONS: This technique compared favorably with other methods of
intervention to avoid early placement of a ventriculoperitoneal shunt in
preterm infants and offered the advantage of consistently decreasing
ventricular size. A multicenter-controlled trial will be needed to compare
the safety and efficacy of therapies for PHH.
