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Posthemorrhagic Hydrocephalus

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Cerebrospinal Fluid Disorders

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Abstract

Intraventricular hemorrhage (IVH) and posthemorrhagic hydrocephalus (PHH) represent two of the most common and debilitating conditions affecting premature neonates. With escalating grades of severity (Grade I–IV), the amount and extent of IVH influence rates of survival, risk of developing PHH requiring treatment, and neurocognitive outcomes. While the diagnosis of IVH relies solely on imaging modalities, the designation of PHH combines radiographic and clinical information. Treatment for PHH involves temporizing measures (typically ventriculo-subgaleal shunt or ventricular access device insertion) or permanent strategies (ventriculoperitoneal shunt [VPS] insertion or endoscopic third ventriculostomy with choroid plexus cauterization [ETV/CPC]) in the appropriate clinical setting. Improved neonatal care and these neurosurgical interventions have helped to reduce overall and hydrocephalus-related mortality rates in premature infants with IVH. However, mortality rates of premature infants with severe IVH remain high. Additionally, patients with severe IVH and PHH frequently exhibit neurocognitive impairment and elevated risks of developing cerebral palsy or epilepsy (Adams-Chapman et al., Pediatrics. 2008;121(5):e1167–77). Current research endeavors focus on the potential utility of cerebrospinal fluid biomarkers and rat models of IVH and PHH to trial novel preventive and therapeutic interventions.

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Abbreviations

AF:

Anterior fontanelle

AVM:

Arteriovenous malformation

CP:

Cerebral palsy

CSF:

Cerebrospinal fluid

EI:

Evans index

ELBW:

Extremely low birth weight

ETV:

Endoscopic third ventriculostomy

ETV/CPC:

Endoscopic third ventriculostomy with choroid plexus cauterization

EVD:

External ventricular drain

FOR:

Frontal/occipital horn ratio

g:

Grams

GA:

Gestational age

GMH:

Germinal matrix hemorrhage

HC:

Head circumference

HCRN:

Hydrocephalus Clinical Research Network

ICP:

Intracranial pressure

IVH:

Intraventricular hemorrhage

kg:

Kilograms

LP:

Lumbar puncture

MDI:

Mental Developmental Index

ml:

Milliliters

MRI:

Magnetic resonance imaging

NICU:

Neonatal intensive care unit

OR:

Odds ratio

PDI:

Psychomotor Development Index

PHH:

Posthemorrhagic hydrocephalus

PHVD:

Posthemorrhagic ventricular dilation

PVHI:

Periventricular hemorrhagic infarction

PVL:

Periventricular leukomalacia

RBC:

Red blood cell

TGF-β:

Transforming growth factor-β

US:

Ultrasound

VAD:

Ventricular access device

VAS:

Ventriculoatrial shunt

VBR:

Ventricular-brain ratio

VPS:

Ventriculoperitoneal shunt

VSGS:

Ventriculo-subgaleal shunt

VLBW:

Very low birth weight

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Authors and Affiliations

  1. Division of Pediatric Neurosurgery, Department of Neurological Surgery, Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus, OH, USA

    Jonathan A. Pindrik

  2. Department of Radiology, Nationwide Children’s Hospital, Columbus, OH, USA

    Mark Halverson

Authors
  1. Jonathan A. Pindrik
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  2. Mark Halverson
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Corresponding author

Correspondence to Jonathan A. Pindrik .

Editor information

Editors and Affiliations

  1. Department of Neurological Surgery, Washington University School of Medicine, St. Louis Children’s Hospital, St. Louis, MO, USA

    David D. Limbrick Jr.

  2. Nationwide Children’s Hospital, Department of Neurosurgery, The Ohio State University College of Medicine, Columbus, OH, USA

    Jeffrey R. Leonard

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Pindrik, J.A., Halverson, M. (2019). Posthemorrhagic Hydrocephalus. In: Limbrick Jr., D., Leonard, J. (eds) Cerebrospinal Fluid Disorders . Springer, Cham. https://doi.org/10.1007/978-3-319-97928-1_8

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  • DOI: https://doi.org/10.1007/978-3-319-97928-1_8

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