Abstract
We studied the efficiency of serial lumbar punctures in the prevention of posthemorrhagic hydrocephalus in thirty preterm infants with moderate to large (Grade III)intraventricular hemorrhage (IVH) or parenchymal extension (Grade IV). Twenty-four infants (BW 1129±324g, GA 29±2 wks) were randomly assigned to the treatment group and fourteen infants (BW 1001±256g, GA 27± 2 wks) to controls. Success, defined as stable or decreased ventricular size, or failure, increasing ventricular size requirinq surgical intervention, was determined by serial neurosonography and clinical signs of hydrocephalus (rapidly increasing head circumference with or without signs of increased intracranial pressure).
The two groups were comparable with respect to race and sex. Seventeen percent of the study infants had Grade IV IVH and overall mortality of 8.3%, as compared to 43% Grade IV IVH and a mortality of 21.4% in the control group. LP's were initiated in the treatment group at 11±5 days of age and lasted for 20.2± 15.7 days. During therapy 16±12 number of taps were done removing 67±101 ml of CSF with an average of 3.2±1.9ml per tap.
Progression to hydrocephalus was found in ten treated (42%) and six control (43%)patients. We conclude that serial LP's do not prevent posthemorrhagic hydrocephalus in preterm infants.
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Anwar, M., Kadam, S., Hiatt, I. et al. THE PREVENTION OF POSTHEMORRHAGIC HYDROCEPHALUS WITH SERIAL LUMBAR PUNCTURES: A CONTROLLED TRIAL. Pediatr Res 18 (Suppl 4), 327 (1984). https://doi.org/10.1203/00006450-198404001-01405
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DOI: https://doi.org/10.1203/00006450-198404001-01405