Intraventricular hemorrhage and posthemorrhagic hydrocephalus in preterm infants: diagnosis, classification, and treatment options

Childs Nerv Syst. 2019 Jun;35(6):917-927. doi: 10.1007/s00381-019-04127-x. Epub 2019 Apr 5.

Abstract

Purpose: Intraventricular hemorrhage is the most important adverse neurologic event for preterm and very low weight birth infants in the neonatal period. This pathology can lead to various delays in motor, language, and cognition development. The aim of this article is to give an overview of the knowledge in diagnosis, classification, and treatment options of this pathology.

Method: A systematic review has been made.

Results: The cranial ultrasound can be used to identify the hemorrhage and grade it according to the modified Papile grading system. There is no standardized protocol of intervention as there are controversial results on which of the temporizing neurosurgical procedures is best and about the appropriate parameters to consider a conversion to ventriculoperitoneal shunt. However, it has been established that the most important prognosis factor is the involvement and damage of the white matter.

Conclusion: More evidence is required to create a standardized protocol that can ensure the best possible outcome for these patients.

Keywords: Intraventricular hemorrhage; Posthemorrhagic hydrocephalus; Ventricular access device; Ventriculoperitoneal shunt; Ventriculosubgaleal shunt.

Publication types

  • Systematic Review

MeSH terms

  • Cerebral Intraventricular Hemorrhage / classification*
  • Cerebral Intraventricular Hemorrhage / diagnosis*
  • Cerebral Intraventricular Hemorrhage / therapy*
  • Female
  • Humans
  • Hydrocephalus / etiology
  • Hydrocephalus / therapy
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases / classification*
  • Infant, Premature, Diseases / diagnosis*
  • Infant, Premature, Diseases / therapy*
  • Male