Abstract
.Dilatation of the cerebral ventricles is a common condition in preterm neonates with intraventricular hemorrhage. This posthemorrhagic ventricle dilatation (PHVD) can lead to lifelong neurological impairment through ischemic injury due to increased intracranial pressure, and without treatment can lead to death. Two-dimensional ultrasound (US) through the fontanelles of the patients is serially acquired to monitor the progression of PHVD. These images are used in conjunction with clinical experience and physical exams to determine when interventional therapies such as needle aspiration of the built up cerebrospinal fluid (ventricle tap, VT) might be indicated for a patient; however, quantitative measurements of the ventricles size are often not performed. We describe the potential utility of the quantitative three-dimensional (3-D) US measurements of ventricle volumes (VVs) in 38 preterm neonates to monitor and manage PHVD. Specifically, we determined 3-D US VV thresholds for patients who received VT in comparison to patients with PHVD who resolve without intervention. In addition, since many patients who have an initial VT will receive subsequent interventions, we determined which PHVD patients will receive additional VT after the initial one has been performed.
Highlights
Despite advances in neonatal care and improved evidence-based perinatal management guidelines, preterm neonates are still at a high risk of morbidity
We present for the first time a preliminary study used to examine whether a 3-D US-based ventricle volumes (VVs) and VV change measurements allow us to prognosticate, which infants with posthemorrhagic ventricle dilatation (PHVD) will receive a temporary intervention and who will have a spontaneous resolution of PHVD
Since most patients with PHVD who have an initial ventricular tap (VT) will go on to have multiple VTs during the course of the stay in the neonatal intensive care unit (NICU), we investigated whether or not image-based measurements could detect whether further treatments would be received
Summary
Despite advances in neonatal care and improved evidence-based perinatal management guidelines, preterm neonates are still at a high risk of morbidity. Intraventricular hemorrhage (IVH), bleeding inside the cerebral ventricles, has been decreasing in prevalence yet remains as a common morbidity among preterm born neonates.[1] The risk of long-term disabilities such as cerebral palsy and cognitive impairment increases significantly with the occurrence of posthemorrhagic hydrocephalus (PHH), the abnormal enlargement of the ventricles, which typically occurs in 25% to 28% of IVH patients with severe bleeds (grades III and IV by the Papile scale2).[3] In general, PHH is thought to be caused by the blood clots and inflammatory reactions from blood breakdown products causing obstruction of the flow of CSF, which normally flows from the ventricles, where CSF is generated to the subarachnoid space where it is reabsorbed into the blood stream.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
