Neuroendoscopic lavage for the management of neonatal post-haemorrhagic hydrocephalus: a retrospective series
| العنوان: | Neuroendoscopic lavage for the management of neonatal post-haemorrhagic hydrocephalus: a retrospective series |
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| المؤلفون: | Susan I Honeyman, Shailendra Magdum, Jayaratnam Jayamohan, Alexandros Boukas |
| المصدر: | Child's Nervous System. 38:115-121 |
| بيانات النشر: | Springer Science and Business Media LLC, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, Ventriculoperitoneal Shunt, Ventriculostomy, Humans, Medicine, Child, Therapeutic Irrigation, Survival rate, Retrospective Studies, Third Ventricle, Csf diversion, business.industry, Optimal treatment, Infant, Newborn, Endoscopic third ventriculostomy, Infant, General Medicine, medicine.disease, Surgery, Hydrocephalus, Treatment Outcome, Child, Preschool, Relative risk, Neuroendoscopy, Pediatrics, Perinatology and Child Health, Premature Birth, Female, Neurology (clinical), Complication, business, Shunt (electrical) |
| الوصف: | Introduction Intraventricular haemorrhage (IVH) is a common complication of preterm birth, and optimal treatment remains uncertain. Neuroendoscopic lavage (NEL) has gained interest as a method for removal of intraventricular haematoma, with outcomes suggesting it to be safe and potentially effective. Methods A retrospective review was carried identifying infants who underwent NEL for post-IVH hydrocephalus at our institution. Data was extracted on patient baseline demographics, comorbidities, complications, re-operation requirement, and neurodevelopmental outcomes. Results Twenty-six patients (17 male) were identified, who underwent NEL at a mean age of 39 weeks and 4 days. Eighteen patients underwent simultaneous endoscopic third ventriculostomy (ETV). Mean patient follow-up was 57.7 months ± 11.8 months. A total of 17/26 patients went on to require a ventriculoperitoneal shunt (VPS). Nine patients did not require further surgical management of hydrocephalus; all had been managed with NEL + ETV. The relative risk of requiring VPS with NEL + ETV compared with NEL alone was 0.500 (CI: 0.315-0.794; p = 0.0033). The 24-month survival rate of VPS inserted following NEL was 64.7%. Exactly 5/26 (19.2%) had post-procedure complications: 2 CSF leaks (7.7%), 2 infections (7.7%), and 1 rebleed within 72 h of NEL (3.8%). On long-term follow-up, 22/25 patients achieved good motor outcome, either walking independently or with mobility aids. A total of 8/15 children attended mainstream schooling with adaption. Discussion NEL is safe and potentially efficacious treatment for neonatal IVH. The procedure may reduce shunt dependence and, for those who require CSF diversion, improve shunt survival. Neurodevelopmentally, good motor and cognitive outcome can be achieved. |
| تدمد: | 1433-0350 0256-7040 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::94dc66878e387350bf81ef99761d330bTest https://doi.org/10.1007/s00381-021-05373-8Test |
| حقوق: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....94dc66878e387350bf81ef99761d330b |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14330350 02567040 |
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