T.S. Park Chair and Chief of Pediatric Neurosurgery, Executive Vice Chair of Neurological Surgery, Washington University School of Medicine; Neurosurgeon-in-Chief, St. Louis Children's Hospital.
Em. Professor in Neonatal Neurology, Department of Neonatology, University Medical Center Utrecht and Leiden University Medical Center, the Netherlands.
Semin Perinatol. 2022 Aug;46(5):151597. doi: 10.1016/j.semperi.2022.151597. Epub 2022 Mar 12.
During the last decade, an increasing number of studies have been conducted to improve the outcome of post-hemorrhagic hydrocephalus (PHH), a complication of severe intraventricular hemorrhage (IVH) in preterm infants. Two randomized controlled trials have shown that treatment should be initiated prior to the onset of clinical symptoms. Ventricular access devices and subgaleal shunts are used as temporary neurosurgical interventions whereas ventriculoperitoneal shunts are performed for infants with progressive hydrocephalus. Recently, techniques such as neuro-endoscopic lavage have also been introduced to eliminate toxic blood products and debris from the cerebral ventricles and have shown promise in early clinical studies. The objective of this review is to provide an update on management of PHVD and PHH in the preterm infant.
在过去的十年中，越来越多的研究旨在改善早产儿严重脑室出血（IVH）后出血性脑积水（PHH）这一并发症的预后。两项随机对照试验表明，治疗应在临床症状出现之前开始。脑室引流装置和皮下分流术被用作临时神经外科干预措施，而对于进行性脑积水的婴儿则进行脑室腹腔分流术。最近，神经内镜冲洗等技术也被引入，以从脑室内清除毒性血液产物和碎片，并在早期临床研究中显示出希望。本文的目的是提供早产儿 PHVD 和 PHH 管理的最新信息。
