Management of intraventricular hemorrhage in neonates / Ahmed Adel Mohamed Ezzat ; Supervised Hazem Abdelbadae , Ehab Eissa , Ahmed Sayed Bayoumy

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Neurosurgery

Introduction: The early management of post hemorrhagic hydrocephalus in premature infants is challenging and controversial. These infants need a temporary cerebrospinal fluid (CSF) diversion procedure until they gain adequate weight, and the blood and protein levels in CSF are reasonably low before permanent shunt can be placed. Various options are available with their associated advantages and disadvantages. Patients and Methods: In a study including 15 neonates with spontaneous Intraventricular hemorrhage due to different causes , close observation was done to choose between different moadalities to manage this condition whether conservative management or operative intervention choosing between either temporary then permanent CSF diversion or permanent diversion from the start with long term follow-up to assess the best management for this serious condition. Results: Fifteen neonates with Intraventricular hemorrhage were identified in our research (Table 3). There were 9 males and 6 females. Age ranged from 19 days to 28 days. IVH was graded according to the Papile classification. The distribution was as follows: Grade 1 (8/15), Grade 2 (3/15), Grade 3 (2/15), and Grade 4 (2/15). The mean follow-up duration was 6 months with 4 deaths. Eleven patients had a follow-up of 6 months. Three of the patients required VSG insertion on admission to our facility followed by a VP shunt insertion; 6 patients received VP shunts. 2 patients received an EVD as a temporary CSF diversion. 4 patients were treated conservatively. Mortality rate four patients (27%) died during their initial hospitalization; no deaths were related to hydrocephalus or shunt insertion

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