Turkish Neurosurgery 2013 , Vol 23 , Num 5
Surgical Treatment Problems of Hydrocephalus Caused by Spontaneus Intraventricular Hemorrhage in Prematurely Born Children
Miljan MIHAJLOVIC1, Vojislav BOGOSAVLJEVIC2,3, Igor NIKOLIC2,3, Milan MRDAK1, Nikola REPAC2, Vuk SCEPANOVIC2, Branislav NESTOROVIC2,3, Goran TASIC2,3
1University Pediatric Hospital, Department of Neurosurgery, Belgrade, Serbia
2Clinical Centre of Serbia, Institute of Neurosurgery, Belgrade, Serbia
3Medical Faculty, Belgrade, Serbia
DOI : 10.5137/1019-5149.JTN.6244-12.1 AIM: The aim of this study was to identify the most appropriate method of surgical treatment of hydrocephalus in preterm infants that is caused by spontaneous intraventricular hemorrhage (IVH) and to identify predictive factors of poor perioperative outcomes.

MATERIAL and METHODS: We present a series of 60 patients with IVH and hydrocephalus, to whom a VP shunt or subcutaneous (Omaya) reservoir was placed, during the period from March 2006 to March 2011.

RESULTS: Predictors of poor outcome with VP shunt placement were: gestational age (t=2.323, p=0.024), head circumference at birth (t=2.072, p=0.043), birth weight (t=2.832, p=0.006), Apgar score at birth (t=5.026, p<0.01), number of days on assisted ventilation (Z=6.203, p <0.001), peripartal asphyxia (χ2 =17.376, p<0.01), respiratory distress (χ2=9.176 p=0.002). Predictors of poor outcome in getting Omaya reservoir are: low birth weight (t=2.560, p=0.016), low Apgar scores (t=3.059, p=0.005), an extended number of days on assisted ventilation (Z=4.404, p<0.001), presence of peripartal asphyxia (χ2=9.977, p=0.002) and cardio-respiratory arrest (χ2=12.804, p<0.001).

CONCLUSION: The outcome of hydrocephalus caused by IVH in premature born children is the worst in perinatology. Our results suggest that the main predictive factor is preoperative condition of the child and that the VP shunt and Omaya reservoir are complementary methods of surgical treatment. Keywords : Hydrocephalus, Premature birth, Intraventricular hemorrhage

Corresponding author : Vojislav Bogosavljevıc, neurobog1171@gmail.com