Germinal matrix hemorrhage and hydrocephalus in premature infants

: An analysis of 25 preterm infants with grade 3 or 4 intraventricular hemorrhage and surgically treated progressive hydrocephalus was undertaken to assess mortality, cognitive outcome and motor deficit. All patients underwent surgery at the author's institute since 1981 and represented 4.7% of all intraventricular hemorrhage in premature infants. Surgical procedure was initial placement of a miniature Ommaya's reservoir and conversion to a ventriculoperitoneal shunt diversion. Overall, outcomes were achieved in 64.7% of ambulatory and improvement of cerebroventricular index on follow-up CT image from 0.68 +/- 0.36% to 0.36 +/- 0.31%. The presence of intraventricular hemorrhage continues to be a major problem in low birth weight infants whose rate survival continues to increase as the major improvements in perinatal medicine. We feel that miniature Ommaya's reservoir is quite helpful in the treatment of posthemorrhagic hydrocephalus in the preterm infant who prove refractory to aggressive conservative therapy.