Abstract
The optimum time for VP shunt placement in infants with posthemorrhagic hydrocephalus is controversial. We studied 28 preterm infants born between 1979-1983 (Mean birthweight 1338±329gm; mean gestational age 30±2wk) in whom serial lumbar punctures failed to control progressive and symptomatic ventriculomegaly after grade III (62%) or grade IV (38%) intraventricular hemorrhage. VP shunts were placed at a median age of 28 days (range 11-78 days). Seventeen infants (61%) required 1 or more shunt revisions and 10(36%) had shunt infections. Three infants died, 1 from a shunt infection. The infants were evaluated with audiologic, ophthalmologic and neurologic examinations. Eight infants (29%) have profound visual loss, 5 of whom have cortical blindness, and 7 (25%) have hearing impairment. Five infants have profound neurological sequelae and 7 have seizure disorders. A developmental quotient(DQ) and motor index (MI) were obtained between 4-12 months adjusted age using the Bayley and/or Knobloch-Geselfl scales. The number of infants having various developmental scores is shown below:
Although nearly 20% of these infants have normal DQ&MI at 1 year of age, progressive posthemorrhagic hydrocephalus is associated with multiple handicaps despite early VP shunt placement. (U.S. Dept. of Ed; HCEEP)
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Boynton, C., Boynton, B., Merritt, T. et al. 1662 EARLY VENTRICULOPERITONEAL (VP) SHUNTS IN INFANTS WEIGHING 2000 GM: NEURODEVELOPMENTAL FOLLOW-UP. Pediatr Res 19, 387 (1985). https://doi.org/10.1203/00006450-198504000-01686
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DOI: https://doi.org/10.1203/00006450-198504000-01686