Department of Neurosurgery, Baylor College of Medicine, Division of Neurosurgery, Texas Children's Hospital, Houston, Texas.
Department of Neurosurgery, Northwestern University School of Medicine, Division of Neurosurgery, Lurie Children's Hospital, Chicago, Illinois, USA.
World Neurosurg. 2021 Sep;153:21-25. doi: 10.1016/j.wneu.2021.06.043. Epub 2021 Jun 16.
Intraventricular hemorrhage (IVH) is common in premature newborns and poses a high risk for morbidity with lifelong disability. We searched the available literature for original and secondary literature regarding the epidemiology, pathogenesis, and treatment of IVH in order to trace changes in the management of this disease over time. We examined IVH pathogenesis and epidemiology and reviewed the history of medical and surgical treatment for intraventricular hemorrhage in preterm children. Initial medical management strategies aimed at correcting coagulopathy and eventually targeted mediators of perinatal instability including respiratory distress. Surgical management centered around cerebrospinal fluid diversion, initially through serial lumbar punctures, progressing to ventriculoperitoneal shunting, with more recent interventions addressing intraventricular clot burden. We provide a historical review of the evolution of treatment for IVH in newborns. While the management of IVH has grown significantly over time, IVH remains a common neurosurgical disease that continues to affect patient and caregiver quality of life and health care costs. Despite advances in treatment over more than a century, IVH remains a significant cause of morbidity and mortality in premature infants, and an understanding of past approaches may inform the development of new treatments.
脑室内出血（IVH）在早产儿中很常见，并且存在很高的发病率风险，导致终身残疾。我们搜索了有关 IVH 的流行病学、发病机制和治疗的现有文献，以追踪随着时间的推移，对这种疾病的管理发生了哪些变化。我们研究了 IVH 的发病机制和流行病学，并回顾了早产儿脑室内出血的医学和手术治疗史。最初的医疗管理策略旨在纠正凝血障碍，最终针对围产期不稳定的介质，包括呼吸窘迫。手术管理集中在脑脊液引流上，最初通过多次腰椎穿刺，进展到脑室-腹腔分流，最近的干预措施则针对脑室内血凝块负担。我们提供了新生儿 IVH 治疗演变的历史回顾。尽管 IVH 的治疗在过去几十年中取得了显著进展，但它仍然是一种常见的神经外科疾病，持续影响患者和照顾者的生活质量和医疗保健成本。尽管在治疗方面取得了一个多世纪的进展，但 IVH 仍然是早产儿发病率和死亡率的重要原因，对过去方法的了解可能为新治疗方法的发展提供信息。
