Management of Post Hemorragic Hydrocephalus in Infants

Abstract

Definitive treatment of progressive PHH is a VP (ventriculoperitoneal) shunt; however, this procedure is rarely used as a first intervention for several reasons: the risk of skin ulceration in very low birth weight infants, the high incidence of shunt malfunction, and frequent need of revision, among others. In many cases, the ventricular dilation will be controlled with the use of temporizing neurosurgical procedures (TNPs): lumbar punctures (LP), external ventricular drainage (EVD), insertion of a ventricular access device (VAD), or a ventriculosubgaleal (VSG) shunt. In cases where PHH is not controlled with these procedures, the placement of a VP shunt is indicated. The lack of conclusive recommendations for the treatment of this pathology makes it very difficult to have a standardized protocol; most centers use institutional guidelines, medical expertise, and available resources to guide their treatment.