Preterm-related posthemorrhagic hydrocephalus: Review of our institutional series with a long-term follow-up.

Fecha de publicación: 09/02/2023 Fecha Ahead of Print: 09/02/2023

Autores de IIS La Fe

Pablo Miranda Lloret

Autor
Nuria Boronat González

Autor

Participantes ajenos a IIS La Fe

Simal, Juan Antonio
Plaza, Estela
Pancucci, Giovanni
Escrig, Raquel
Llorens, Roberto

Grupos

Investigación Clínica y Traslacional en Cáncer

Leader

José Gómez Codina
Perinatología

Leader

Máximo Vento Torres

Abstract

INTRODUCTION: Preterm-related posthemorrhagic hydrocephalus is a major cause of neurological impairment and a common indication for a ventriculoperitoneal shunt in infants that are prone to diverse complications. Protocols of diagnosis and treatment are in continuous evolution and require evaluation of their results. OBJECTIVE: To review the clinical characteristics and results of a series of preterm-related posthemorrhagic hydrocephalus needing a definitive shunt from 1982 to 2020 in our institution. As a secondary objective we evaluated the safety of the changes in our protocol of treatment from 2015. METHODS: Retrospective review, clinical investigation. RESULTS: 133 patients were implanted a shunt in the study period. Shunt infection was diagnosed in 15 patients. Proximal shunt obstruction as the first complication was diagnosed in 30% of cases at one year, 37% at two years and 46% at five years. 61 patients developed very small or collapsed ventricles at last follow-up. Two thirds of our patients achieved normal neurological development or mild impairment. Changes in protocol did not significantly modify clinical results although improvement in most outcomes was observed. Mean follow-up was over nine years. CONCLUSIONS: Clinical outcomes are comparable to previous reported data. Changes in protocol proved to be safe and improved our results. Programmable shunts can be used safely in preterm patients although they may not prevent tendency towards ventricular collapse, which is very common after long follow-up.

Datos de la publicación

ISSN/ISSNe:: 2529-8496, 2529-8496
Tipo:: Article
Páginas:: 122-127
DOI:: 10.1016/j.neucie.2022.11.009

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Métricas

Filiaciones

Miranda, Pablo:: Servicio de Neurocirugía, Hospital Universitario y Politécnico La Fe, Valencia, Spain
Simal, Juan Antonio:: Servicio de Neurocirugía, Hospital Universitario y Politécnico La Fe, Valencia, Spain
Plaza, Estela:: Servicio de Neurocirugía, Hospital Universitario y Politécnico La Fe, Valencia, Spain
Pancucci, Giovanni:: Servicio de Neurocirugía, Hospital Universitario y Politécnico La Fe, Valencia, Spain
Escrig, Raquel:: Servicio de Neonatología, Hospital Universitario y Politécnico La Fe, Valencia, Spain
Boronat, Nuria:: Servicio de Neonatología, Hospital Universitario y Politécnico La Fe, Valencia, Spain
Llorens, Roberto:: Servicio de Radiología Pediátrica, Hospital Universitario y Politécnico La Fe, Valencia, Spain

Keywords

Complicaciones; Complication; Derivación; Development; Hidrocefalia poshemorrágica; Neurodesarrollo; Poshemorrhagic hydrocephalus; Prematuro; Preterm; Shunt