Advancing the management of neonatal hemorrhages: clinical evaluation of external ventricular drainage efficacy

Abstract

Objective: To evaluate the clinical efficacy of external ventricular drainage (EVD) in the treatment of neonatal intraventricular hemorrhage (IVH).

Methods: A retrospective analysis was conducted on the clinical data of neonates with IVH admitted to the Department of Neurosurgery at Qingdao Women and Children's Hospital from January 2018 to February 2024. All patients received a definitive diagnosis followed by EVD treatment. Regular follow-ups were conducted, and patients who developed posthemorrhagic hydrocephalus (PHH) underwent ventriculoperitoneal shunt (VPS) procedures.

Results: Among the 44 neonates with IVH, 28 were male and 16 were female. The median gestational age at birth was 36 weeks (range: 24-40 weeks), and the median birth weight was 2.9 kg (range: 0.78-4.33 kg). There were 3 cases of grade II IVH, 34 cases of grade III IVH, and 7 cases of grade IV IVH. The average duration of EVD was 12.2 ± 5.6 days. All patients were followed up for at least 1 year. Twelve patients (27%) developed hydrocephalus, of which 8 cases (18%) with progressive ventricular enlargement underwent VPS, and 4 cases (9%) had arrested hydrocephalus and remained stable without VPS. During the follow-up period, 39 patients exhibited normal development, 3 patients (6.8%) developed epilepsy, and 2 patients (4.5%) developed cerebral palsy.

Conclusion: EVD is an effective treatment for intraventricular hemorrhage. It improves survival rates and outcomes for patients while effectively reducing the incidence of hydrocephalus.

Keywords: Intraventricular hemorrhage; Neonates; Posthemorrhagic hydrocephalus; Surgical treatment.