Article Text

MEDIUM TERM NEUROLOGICAL OUTCOME IN A GROUP OF PRETERM INFANTS SURGICALLY TREATED FOR POSTHAEMORRHAGIC VENTRICULAR DILATATION (PHVD)
  1. B Caravale1,
  2. F Campi1,
  3. F Lozzi1,
  4. J Rechichi1,
  5. P Giliberti1,
  6. C DeMarchis1,
  7. M F Coletti1,
  8. L Rava’2,
  9. G Seganti1,
  10. C Corchia1
  1. 1Department of Medical and Surgical Neonatology, Bambino Gesú Children’s Hospital, Rome, Italy
  2. 2Unit of Epidemiology and Biostatistics, Bambino Gesú Children’s Hospital, Rome, Italy

Abstract

Objective To investigate the outcome of a group of preterm infants with PHVD treated with external ventricular drainage (EVD) and/or ventriculoperitoneal shunt (VPS).

Methods Study group comprised 29 preterm infants (24–36 wks of gestation), born between 2003–2007, diagnosed as having a grade III–IV IVH and who developed PHVD; twenty six of them were referred to our hospital for treatment. Neurological assessment was performed at 12 and 24 months corrected age (CA).

Results Mean gestational age (GA) was 29 wks (DS 3), mean birth weight 1277 g (DS 510); 24 newborns were <32 wks GA. Primary intervention was EVD at a mean age of 34 days of life; this was followed by 17% of cerebrospinal fluid infections. VPS was placed in 96% of the infants, 52% of whom needed at least one more surgical replacement. Twenty children were evaluated at 12 months CA: 40% had epilepsy, 80% motor impairment and 95% at least one of them. Fifteen children were evaluated at 24 months CA, and 67% had cerebral palsy (CP).

Conclusions PHVD is a serious illness complicating grade III–IV IVH, that mainly affects newborn infants <32 wks gestation. In our series, neurological sequelae were present in nearly all babies at 12 months CA, and CP was diagnosed in two thirds of those evaluated at 24 months. Long-term follow-up may allow us to estimate the prevalence of neurological impairments, to give prognostic information, and possibly to evaluate the impact of medical and surgical treatments.

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