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

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43 Scopus citations

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 - 1 Nov 2012
Externally publishedYes

Keywords

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

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