TY - JOUR
T1 - Timing of external ventricular drainage and neurodevelopmental outcome in preterm infants with posthemorrhagic hydrocephalus
AU - Bassan, Haim
AU - Eshel, Rina
AU - Golan, Inbal
AU - Kohelet, David
AU - Ben Sira, Liat
AU - Mandel, Dror
AU - Levi, Loren
AU - Constantini, Shlomi
AU - Beni-Adani, Liana
N1 - Funding Information:
This study was supported by the Tel Aviv Sourasky Medical Center research fund. We thank the children and their families for participating in this study. We are also most grateful to the EVD Study collaborators who made this report possible: Ronella Marom, Shaul Dolberg, Irit Berger, Mila Barak, Francis B. Mimouni (Tel-Aviv Sourasky Medical Center), Beni Baroz, Ilan Arad (Hadassah Mount Scopus, Jerusalem), Dan Engelhard, Ofra Peleg (Hadassah Ein Kerem, Jerusalem), Tzipora Dolfin (Meir Medical Center, Kfar-Saba), Eliana Arbel, (Edith Wolfson Medical Center, Hulon), Dani Reich, Marina Peniakov, Klari Felser (Emek Medical Center, Afula), Omri Hussam, Yousif Nijim (Nazareth Hospitals), Yoram Bental, Yakov Shiff, Meir Weisbrod (Sanz Medical Center, Laniado, Natanya), David Bader, Martha Abend, Amir Kugelman (Bnai Zion Medical Center), Shmuel Yurman, Erez Nadir, Michael Feldman (Hillel Yaffe Medical Center), Eric S. Shinwell (Kaplan Hospital, Rehovot), Dror Sade, (Western Galilee Hospital, Nahariya), Amir Kushnir, (The Baruch Padeh Medical Center, Poriya), Ilan Gur (Bikur Cholim Medical Center, Jerusalem), Eli Heyman (Assaf Harofeh Medical Center, Zerifin).
PY - 2012/11
Y1 - 2012/11
N2 - Objective: To delineate the impact of early (≤25 days of life) versus late (>25 days) external ventricular drainage (EVD) on the neurodevelopmental outcome of preterm infants with posthemorrhagic hydrocephalus (PHH) following intraventricular hemorrhage (IVH). Methods: We retrospectively categorized 32 premature infants with PHH into two groups according to whether they underwent early (n = 10) or late (n = 22) EVD. We administered the Battelle Developmental Inventory II and a neuromotor examination (median age, 73 months, range: 29-100). Results: In adjusted comparisons, early EVD was associated with better scores than late EVD in adaptive (79 ± 22.6 vs. 58.8 ± 8.1, P = .01), personal social (90.7 ± 26 vs. 67.3 ± 15.9, P = .02), communication (95.4 ± 27.5 vs. 69.6 ± 20.5, P = .04) and cognitive (78.9 ± 24.4 vs. 60.7 ± 11.5, P = .055) functions. Three (30%) early EVD infants had severe (<2.5 standard deviation) cognitive disability compared to 18 (82%) late EVD infants (P = .03). The incidences of cerebral palsy and neurosurgical complications were equal for the two groups. Subgroup analyses suggested that early EVD was beneficial in infants with original grade III IVH (n = 15, P < 0.05), but that it had no beneficial effects in infants with prior parenchymal injury (n = 17, P = NS). Conclusion: In this small retrospective series, early EVD is associated with lower rates of cognitive, communication and social disabilities than later EVD in infants with PHH without prior parenchymal injury. A randomized prospective trial is warranted.
AB - Objective: To delineate the impact of early (≤25 days of life) versus late (>25 days) external ventricular drainage (EVD) on the neurodevelopmental outcome of preterm infants with posthemorrhagic hydrocephalus (PHH) following intraventricular hemorrhage (IVH). Methods: We retrospectively categorized 32 premature infants with PHH into two groups according to whether they underwent early (n = 10) or late (n = 22) EVD. We administered the Battelle Developmental Inventory II and a neuromotor examination (median age, 73 months, range: 29-100). Results: In adjusted comparisons, early EVD was associated with better scores than late EVD in adaptive (79 ± 22.6 vs. 58.8 ± 8.1, P = .01), personal social (90.7 ± 26 vs. 67.3 ± 15.9, P = .02), communication (95.4 ± 27.5 vs. 69.6 ± 20.5, P = .04) and cognitive (78.9 ± 24.4 vs. 60.7 ± 11.5, P = .055) functions. Three (30%) early EVD infants had severe (<2.5 standard deviation) cognitive disability compared to 18 (82%) late EVD infants (P = .03). The incidences of cerebral palsy and neurosurgical complications were equal for the two groups. Subgroup analyses suggested that early EVD was beneficial in infants with original grade III IVH (n = 15, P < 0.05), but that it had no beneficial effects in infants with prior parenchymal injury (n = 17, P = NS). Conclusion: In this small retrospective series, early EVD is associated with lower rates of cognitive, communication and social disabilities than later EVD in infants with PHH without prior parenchymal injury. A randomized prospective trial is warranted.
KW - Cognitive function
KW - Early
KW - Hydrocephalus
KW - Intraventricular hemorrhage
KW - Outcome
KW - Treatment
UR - http://www.scopus.com/inward/record.url?scp=84867096816&partnerID=8YFLogxK
U2 - 10.1016/j.ejpn.2012.04.002
DO - 10.1016/j.ejpn.2012.04.002
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C2 - 22591810
AN - SCOPUS:84867096816
SN - 1090-3798
VL - 16
SP - 662
EP - 670
JO - European Journal of Paediatric Neurology
JF - European Journal of Paediatric Neurology
IS - 6
ER -