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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2017; 75(07): 433-438
DOI: 10.1590/0004-282X20170060
ARTICLES

Cerebrospinal fluid drainage options for posthemorrhagic hydrocephalus in premature neonates

Opções de drenagem liquórica em neonatos prematuros com hidrocefalia pós hemorrágica
José Roberto Tude Melo
1   Hospital Pediátrico Martagão Gesteira, Unidade de Neurocirurgia Pediátrica, Salvador BA, Brasil;
,
Rosane Klein Passos
2   Hospital Pediátrico Martagão Gesteira, Unidade de Radiologia, Salvador BA, Brasil.
,
Marcelo Liberato Coelho Mendes de Carvalho
1   Hospital Pediátrico Martagão Gesteira, Unidade de Neurocirurgia Pediátrica, Salvador BA, Brasil;
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ABSTRACT

Objective

The literature describes various cerebrospinal fluid (CSF) drainage techniques to alleviate posthemorrhagic hydrocephalus in preterm newborns; however, consensus has not been reached. The scope of this study was describing a case series of premature neonates with posthemorrhagic hydrocephalus and assessing the outcomes of different approaches used for CSF diversion.

Methods

A consecutive review of the medical records of neonates with posthemorrhagic hydrocephalus treated with CSF drainage was conducted.

Results

Forty premature neonates were included. Serial lumbar puncture, ventriculosubgaleal shunt, and ventriculoperitoneal shunt were the treatments of choice in 25%, 37.5% and 37.5% of the cases, respectively.

Conclusion

Cerebrospinal fluid diversion should be tailored to each case with preference given to temporary CSF drainage in neonates with lower age and lower birth-weight, while the permanent ventriculoperitoneal shunt should be considered in healthier, higher birth-weight neonates born closer to term.

RESUMO

Objetivo

A literatura descreve várias opções de drenagem liquórica (DL) para alivio da hidrocefalia pós-hemorrágica (HPH) em neonatos prematuros; contudo, não existe um consenso sobre a melhor abordagem. O escopo deste estudo foi descrever uma série de casos de neonatos prematuros, portadores de HPH, verificando os resultados de diferentes técnicas utilizadas para DL.

Métodos

Revisão consecutiva dos prontuários de neonatos com diagnostico de HPH submetidos a DL.

Resultados

Quarenta recém-nascidos prematuros foram incluídos. A punção lombar seriada (PL), a derivação ventriculosubgaleal (VSG) e a derivação ventrículo peritoneal (VP) foram o tratamento escolhido em 25%, 37,5% e 37,5% dos casos, respectivamente.

Conclusão

As opções de DL devem ser avaliadas caso a caso, sendo dada preferência às drenagens temporária em prematuros com idade e peso mais baixos ao nascer, enquanto o shunt definitivo (derivação VP) pode ser considerado naqueles prematuros mais saudáveis, com idade e peso superiores.

cerebral hemorrhage - hydrocephalus - cerebrospinal fluid
hemorragia cerebral - hidrocefalia - líquido cefalorraquidiano


Publication History

Received: 20 January 2016

Accepted: 14 March 2017

Article published online:
05 September 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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