Charlotte d'Arcangues1, Matthias Schulz2, Christoph Bührer1, Ulrich Thome3, Matthias Krause4, Ulrich-Wilhelm Thomale5. 1. Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Neonatology, Charité Universitätsmedizin, Berlin, Germany. 2. Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Pediatric Neurosurgery, Berlin, Germany. 3. Department of Neonatology, University of Leipzig, Leipzig, Germany. 4. Department of Neurosurgery, Pediatric Neurosurgery, University of Leipzig, Germany. 5. Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Pediatric Neurosurgery, Berlin, Germany. Electronic address: uthomale@charite.de.
Abstract
OBJECTIVE: Previous studies have described neuroendoscopic lavage (NEL) as a procedure for the treatment of posthemorrhagic hydrocephalus in newborn infants. This report describes complications and results in an extended case series from 2 separate hospitals. METHODS: Patient records were screened for NEL procedures performed on infants with posthemorrhagic hydrocephalus between September 2010 and May 2016 (minimum follow-up period of 12 months). Efficacy of blood removal-as assessed with cerebral ultrasound, complications, eventual shunt placement rate, and subsequent shunt revisions-were recorded. RESULTS: Fifty-six patients (35 male) underwent NEL at a postmenstrual median age of 31 weeks and 2 days (range, 26 weeks and 1 day to 52 weeks and 3 days) and a median weight of 1523 g (range, 734-4360 g). Median follow-up was 34 months (range, 12-80). Three patients died, and 31 patients required permanent ventriculoperitoneal shunting. There was no significant correlation between the need for ventriculoperitoneal shunting and gestational age (P = 0.05), birth weight (P = 0.07), age (P = 0.17), or weight (P = 0.59) after NEL. The median number of surgical interventions per patient was 2 (range, 1-7 interventions). Revision-free shunt survival was 63.6% at 12 and 56.2% at 24 months. CONCLUSIONS: NEL avoided shunt placement in 43% of newborn infants with posthemorrhagic hydrocephalus. In the shunted cohort, NEL may have also decreased the frequency of subsequent shunt revisions. The influence of NEL on neurodevelopment and safety remains to be investigated further in a multicenter setup.
OBJECTIVE: Previous studies have described neuroendoscopic lavage (NEL) as a procedure for the treatment of posthemorrhagic hydrocephalus in newborn infants. This report describes complications and results in an extended case series from 2 separate hospitals. METHODS:Patient records were screened for NEL procedures performed on infants with posthemorrhagic hydrocephalus between September 2010 and May 2016 (minimum follow-up period of 12 months). Efficacy of blood removal-as assessed with cerebral ultrasound, complications, eventual shunt placement rate, and subsequent shunt revisions-were recorded. RESULTS: Fifty-six patients (35 male) underwent NEL at a postmenstrual median age of 31 weeks and 2 days (range, 26 weeks and 1 day to 52 weeks and 3 days) and a median weight of 1523 g (range, 734-4360 g). Median follow-up was 34 months (range, 12-80). Three patients died, and 31 patients required permanent ventriculoperitoneal shunting. There was no significant correlation between the need for ventriculoperitoneal shunting and gestational age (P = 0.05), birth weight (P = 0.07), age (P = 0.17), or weight (P = 0.59) after NEL. The median number of surgical interventions per patient was 2 (range, 1-7 interventions). Revision-free shunt survival was 63.6% at 12 and 56.2% at 24 months. CONCLUSIONS: NEL avoided shunt placement in 43% of newborn infants with posthemorrhagic hydrocephalus. In the shunted cohort, NEL may have also decreased the frequency of subsequent shunt revisions. The influence of NEL on neurodevelopment and safety remains to be investigated further in a multicenter setup.
Authors: Ulrich-Wilhelm Thomale; Giuseppe Cinalli; Abhaya V Kulkarni; Sara Al-Hakim; Jonathan Roth; Andreas Schaumann; Christoph Bührer; Sergio Cavalheiro; Spyros Sgouros; Shlomi Constantini; Hans Christoph Bock Journal: Childs Nerv Syst Date: 2019-02-06 Impact factor: 1.475
Authors: Mohamed El-Dib; David D Limbrick; Terrie Inder; Andrew Whitelaw; Abhaya V Kulkarni; Benjamin Warf; Joseph J Volpe; Linda S de Vries Journal: J Pediatr Date: 2020-07-30 Impact factor: 4.406