Outcomes of temporizing measures for posthemorrhagic hydrocephalus in infants
This prospective observational study evaluated efficacy and treatment outcomes for temporizing CSF approaches utilizing ventricular reservoirs (VR) and ventriculosubgaleal shunts (VSG) for management of post hemorrhagic hydrocephalus in infants. Previous retrospective studies have reported similar conversion and complication rates for the two approaches. However, this multicentric study utilized standardized criteria for patient selection, decision making and management of CSF diversion in post hemorrhagic hydrocephalus infants. Infants with grades III-IV hemorrhage were treated with either VR or VSG, in a nonrandomized approach, if their body weight was <1500gms and they met uniform criteria for symptomatic hydrocephalus. The primary outcome measure of conversion to a permanent VPS was not different (63.5% for VSGS and 74.0% for VR) between the 2 groups. The complication rates were also similar. This study is limited by its non-randomized selection approach, but to date, is the only multicenter study of its kind to show similar outcome measures for temporizing CSF diversion techniques.