Outcome for Hydrocephalus After Intraventricular Hemorrhage in Infants

The long-term neurodevelopmental outcome for infants affected with IVH has been and remains an important topic of research. Major issues under investigation are the extent of hemorrhage (grade), coexistent parenchymal injury, and progression of compensated ventriculomegaly. With modern neonatal treatment and proactive management of active hydrocephalus, the outcome for premature infants with PHH has improved in the last two decades. Nevertheless, prematurity is associated also with other health problems, including cardiac, respiratory, and neurodevelopmental defects, which can themselves affect the long-term development of the child. Follow-up should extend to childhood or even adolescence in order to unveil minor cognitive and neuropsychological deficits.

Outcome After Surgery

• Outcome dependent on treatment needed: The impact of progressive ventriculomegaly on neurodevelopmental outcome depends on the need for shunt insertion and the possible complications of this treatment option. Infants developing ventriculomegaly without signs of raised ICP have a more favorable outcome than those with signs of progressive ventricular dilation requiring shunt insertion. A recent study suggests that extremely low-birth-weight children (<1000 g) with severe IVH that requires shunt insertion are at greater risk for adverse neurodevelopmental and growth outcomes compared with children without shunts, with or without severe IVH (1).