Timing of external ventricular drainage and neurodevelopmental outcome in preterm infants with posthemorrhagic hydrocephalus

Haim Bassan*, Rina Eshel, Inbal Golan, David Kohelet, Liat Ben Sira, Dror Mandel, Loren Levi, Shlomi Constantini, Liana Beni-Adani

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)662-670
Number of pages9
JournalEuropean Journal of Paediatric Neurology
Volume16
Issue number6
DOIs
StatePublished - Nov 2012

Funding

FundersFunder number
Tel Aviv Sourasky Medical Center

    Keywords

    • Cognitive function
    • Early
    • Hydrocephalus
    • Intraventricular hemorrhage
    • Outcome
    • Treatment

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