Advantages of delayed VP shunting in post-haemorrhagic hydrocephalus seen in low-birth-weight infants

The optimal timing of ventriculo-peritoneal (VP) shunt insertion in a neonate with post-haemorrhagic hydrocephalus (PHH) is uncertain. During the 8-year period from January 1989 to December 1996, 41 patients had VP shunts inserted for PHH at Red Cross War Memorial Children's Hospital. Data on 3...

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Bibliographic Details
Published in:Child's nervous system 2001-05, Vol.17 (6), p.328-333
Main Authors: TAYLOR, Allan G, PETER, Jonathan C
Format: Article
Language:English
Subjects:
Age Factors
Biological and medical sciences
Cerebral Hemorrhage - mortality
Cerebral Hemorrhage - surgery
Cerebrospinal fluid. Meninges. Spinal cord
Female
Follow-Up Studies
Humans
Hydrocephalus - mortality
Hydrocephalus - surgery
Infant
Infant, Low Birth Weight
Infant, Newborn
Infant, Premature, Diseases - mortality
Infant, Premature, Diseases - surgery
Male
Medical sciences
Nervous system (semeiology, syndromes)
Neurology
Postoperative Complications - mortality
Postoperative Complications - surgery
Reoperation
Survival Rate
Ventriculoperitoneal Shunt
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Summary:The optimal timing of ventriculo-peritoneal (VP) shunt insertion in a neonate with post-haemorrhagic hydrocephalus (PHH) is uncertain. During the 8-year period from January 1989 to December 1996, 41 patients had VP shunts inserted for PHH at Red Cross War Memorial Children's Hospital. Data on 36 patients were sufficient for review in order to determine whether the timing of surgery in any way influenced the complication incidence of this intervention. Nine of the 36 patients had a serious complication, either infection or mechanical shunt obstruction, during their initial hospital admission (early period). Nineteen patients had surgery performed before day 35 after birth and all those with early complications were in this group. Seventeen patients had surgery delayed until after day 35, and none of these patients had an early complication. In this study a higher complication incidence was noted when a VP shunt was inserted prior to day 35 (Chi-square test P < 0.01). This most probably correlates with a high concentration of blood breakdown products in the cerebrospinal fluid during the first month after intra-ventricular haemorrhage.
ISSN:0256-7040
1433-0350
DOI:10.1007/s003810000429