Ventriculosubgaleal shunting in the treatment of posthemorrhagic hydrocephalus of premature infants: case series

Introduction: Posthemorrhagic hydrocephalus(PHH) comprises the most common complication in preterm infants (PTI) who suffered germinative matrix hemorrhage (GMH), and its treatment is still matter of controversies. These infants usually weigh less than 1,500g and a temporary CSF diversion is neede...

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Autor principal:	Alexandre Canheu
Formato:	article
Lenguaje:	EN
Publicado:	Brazilian Society for Pediatric Neurosurgery 2021
Materias:	ventriculosubgaleal shunting posthemorrhagic hydrocephalus intraventricular hemorrhage subgaleal shunting preterm infants Pediatrics RJ1-570 Surgery RD1-811
Acceso en línea:	https://doaj.org/article/392f76e1a4f44a818e96e5f12d4df0cd
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spelling	oai:doaj.org-article:392f76e1a4f44a818e96e5f12d4df0cd2021-11-23T21:46:36ZVentriculosubgaleal shunting in the treatment of posthemorrhagic hydrocephalus of premature infants: case series2675-362610.46900/apn.v3i1(January-April).36https://doaj.org/article/392f76e1a4f44a818e96e5f12d4df0cd2021-01-01T00:00:00Zhttps://www.archpedneurosurg.com.br/pkp/index.php/sbnped2019/article/view/36https://doaj.org/toc/2675-3626Introduction: Posthemorrhagic hydrocephalus(PHH) comprises the most common complication in preterm infants (PTI) who suffered germinative matrix hemorrhage (GMH), and its treatment is still matter of controversies. These infants usually weigh less than 1,500g and a temporary CSF diversion is needed. VSGS is preferred in those cases because it is a simple and rapid method, no need for repetitive aspiration for the evacuation of CSF, gives a permanent decompression without causing electrolyte and nutritional losses, and still protects the cerebral development of newborns with GMH. Methods: We analyzed a series of 22 PTI who underwent VSGS for PHH, between July 2015 and April 2019, and minimum follow-up 6 months. The median gestation age was 28 weeks (range 23-32). The median weigh was 985g (range 625-1615). The mean period harboring de VSGS was 61,8 days (range 35-80). Results: The cases were studied for: 1) Shunt dependency: 11 children (50%) showed persistent hydrocephalus at further investigation and underwent to VP shunt after stable clinical condition. 2) Infection: 6 subjects (27,2%) showed positive cultures, and were converted to External Ventricular Device (EVD), and further VP shunt; 3) Outcome: the results were separated in Excellent/Good (GOS 5-4) 12 subjects (54%); Poor (GOS 3-2): 8 subjects (36%) and Death (GOS 1): 2 subjects (10%). Conclusions: VSGS is a good alternative method to treat PHH, especially in a preterm infant who needs a temporary shunt device. The low rate of severe complications and encouraging results about persistent hydrocephalus should guide further investigation and larger cases series.Alexandre CanheuBrazilian Society for Pediatric Neurosurgeryarticleventriculosubgaleal shuntingposthemorrhagic hydrocephalusintraventricular hemorrhagesubgaleal shuntingpreterm infantsPediatricsRJ1-570SurgeryRD1-811ENArchives of Pediatric Neurosurgery, Vol 3, Iss 1(January-April), Pp e362021-e362021 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	ventriculosubgaleal shunting posthemorrhagic hydrocephalus intraventricular hemorrhage subgaleal shunting preterm infants Pediatrics RJ1-570 Surgery RD1-811
spellingShingle	ventriculosubgaleal shunting posthemorrhagic hydrocephalus intraventricular hemorrhage subgaleal shunting preterm infants Pediatrics RJ1-570 Surgery RD1-811 Alexandre Canheu Ventriculosubgaleal shunting in the treatment of posthemorrhagic hydrocephalus of premature infants: case series
description	Introduction: Posthemorrhagic hydrocephalus(PHH) comprises the most common complication in preterm infants (PTI) who suffered germinative matrix hemorrhage (GMH), and its treatment is still matter of controversies. These infants usually weigh less than 1,500g and a temporary CSF diversion is needed. VSGS is preferred in those cases because it is a simple and rapid method, no need for repetitive aspiration for the evacuation of CSF, gives a permanent decompression without causing electrolyte and nutritional losses, and still protects the cerebral development of newborns with GMH. Methods: We analyzed a series of 22 PTI who underwent VSGS for PHH, between July 2015 and April 2019, and minimum follow-up 6 months. The median gestation age was 28 weeks (range 23-32). The median weigh was 985g (range 625-1615). The mean period harboring de VSGS was 61,8 days (range 35-80). Results: The cases were studied for: 1) Shunt dependency: 11 children (50%) showed persistent hydrocephalus at further investigation and underwent to VP shunt after stable clinical condition. 2) Infection: 6 subjects (27,2%) showed positive cultures, and were converted to External Ventricular Device (EVD), and further VP shunt; 3) Outcome: the results were separated in Excellent/Good (GOS 5-4) 12 subjects (54%); Poor (GOS 3-2): 8 subjects (36%) and Death (GOS 1): 2 subjects (10%). Conclusions: VSGS is a good alternative method to treat PHH, especially in a preterm infant who needs a temporary shunt device. The low rate of severe complications and encouraging results about persistent hydrocephalus should guide further investigation and larger cases series.
format	article
author	Alexandre Canheu
author_facet	Alexandre Canheu
author_sort	Alexandre Canheu
title	Ventriculosubgaleal shunting in the treatment of posthemorrhagic hydrocephalus of premature infants: case series
title_short	Ventriculosubgaleal shunting in the treatment of posthemorrhagic hydrocephalus of premature infants: case series
title_full	Ventriculosubgaleal shunting in the treatment of posthemorrhagic hydrocephalus of premature infants: case series
title_fullStr	Ventriculosubgaleal shunting in the treatment of posthemorrhagic hydrocephalus of premature infants: case series
title_full_unstemmed	Ventriculosubgaleal shunting in the treatment of posthemorrhagic hydrocephalus of premature infants: case series
title_sort	ventriculosubgaleal shunting in the treatment of posthemorrhagic hydrocephalus of premature infants: case series
publisher	Brazilian Society for Pediatric Neurosurgery
publishDate	2021
url	https://doaj.org/article/392f76e1a4f44a818e96e5f12d4df0cd
work_keys_str_mv	AT alexandrecanheu ventriculosubgalealshuntinginthetreatmentofposthemorrhagichydrocephalusofprematureinfantscaseseries
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Ventriculosubgaleal shunting in the treatment of posthemorrhagic hydrocephalus of premature infants: case series

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