224 - Infantile Post-hemorrhagic Hydrocephalus

Abstract

Intraventricular hemorrhage (IVH) in infants is a leading cause of infantile hydrocephalus in the United States, whereas postinfectious hydrocephalus is the leading cause of hydrocephalus worldwide. Management of hydrocephalus in neonates and infants is critical because the initial neonatal management can have lifelong implications for both hydrocephalus treatment and the child’s neurological outcome and quality of life. Although aggressive treatment of hydrocephalus will optimize neurodevelopmental outcomes, it is key that families also realize that hydrocephalus and its management is just one component of their child’s overall complex neurological and medical outcome, and that treatment of hydrocephalus does not prevent other challenges. An understanding of the unique challenges in caring for these infants is essential to their proper management. IVH and subsequent post-hemorrhagic hydrocephalus (PHH) in preterm and term infants arise from different pathophysiologic mechanisms, pose different clinical and management issues, and suggest different prognoses. Therefore, these two entities are discussed separately. In addition, postinfectious hydrocephalus (PIH) and posttraumatic hydrocephalus (PTH) of infancy share many similarities in pathophysiologic mechanisms and management strategies with PHH and will be briefly reviewed in this chapter.