Allan W C, Holt P J, Sawyer L R, Tito A M, Meade S K
Am J Dis Child. 1982 Jul;136(7):589-93. doi: 10.1001/archpedi.1982.03970430021006.
Infants with periventricular-intraventricular hemorrhage (PV-IVH) were followed up with weekly ultrasound sector scans to define the natural history of late ventricular dilation (ie, dilation in excess of that seen at the time of diagnosis of PV-IVH). Infants fell into two groups: (1) posthemorrhagic hydrocephalus (PHH), dilation that produced an increase in occipitofrontal circumference greater than 2 cm per week and/or clinical symptoms of increased intracranial pressure; and (2) ventriculomegaly (VM), dilation that stabilized or reversed without producing these effects. The former was directly related to the severity of hemorrhage. The diameter of the lateral ventricle was significantly greater in PHH. In 26 of 48 infants at risk, late dilation developed: 14 had VM and 12 had PHH. Thus, late ventricular dilation stabilized or resolved spontaneously in 54%. Only three infants eventually required a ventriculoperitoneal shunt. Clinical changes in addition to ventricular size should be used in assessing the need for treatment of ventricular dilation after PV-IVH.
对患有脑室周围-脑室内出血（PV-IVH）的婴儿进行每周一次的超声扇形扫描随访，以明确晚期脑室扩张（即超过PV-IVH诊断时所见扩张程度的扩张）的自然病程。婴儿分为两组：（1）出血后脑积水（PHH），其扩张导致枕额周长每周增加超过2厘米和/或出现颅内压升高的临床症状；（2）脑室扩大（VM），其扩张稳定或逆转，未产生这些影响。前者与出血严重程度直接相关。PHH患儿侧脑室直径明显更大。在48名有风险的婴儿中，26名出现晚期扩张：14名有VM，12名有PHH。因此，54%的晚期脑室扩张自发稳定或消退。最终只有三名婴儿需要进行脑室腹腔分流术。评估PV-IVH后脑室扩张的治疗需求时，除了脑室大小外，还应考虑临床变化。
