Post-Hemorrhagic Hydrocephalus — Concern — Clinical Pathway: ICU

Post-Hemorrhagic Hydrocephalus in Pre-Term Infants Clinical Pathway — N/IICU

Concern for Evolving Hydrocephalus after Intraventricular Hemorrhage (IVH)

Hydrocephalus after intraventricular hemorrhage (IVH) continues to be a major cause of future morbidity. 25% of premature infants will have some form of IVH, with 10% of those having the most severe forms: grade III and IV. Up to half of those with grades III/IV will develop progressive hydrocephalus with likely future neurodevelopmental impairment.

For premature infants with evolving hydrocephalus, proven management options are limited and the current standard of care relies upon decompressing brain pressure through implantation of either a shunt (if infant is large enough and remote from initial bleed) or, if less than 1500 grams, a reservoir to facilitate intermittent cerebrospinal fluid drainage.