Prediction of short- and long-term outcomes using pre-operative ventricular size in infants with post-hemorrhagic ventricular dilation. Childs Nerv Syst 2024 Jul;40(7):2061-2069
Date
03/27/2024Pubmed ID
38532147DOI
10.1007/s00381-024-06371-2Scopus ID
2-s2.0-85188616293 (requires institutional sign-in at Scopus site) 1 CitationAbstract
PURPOSE: Post-hemorrhagic ventricular dilation (PHVD) leads to developmental delays in premature infants, yet the optimal timing of neurosurgical interventions is unknown. Neuroimaging modalities have emerged to delineate injury and follow the progression of PHVD. Fronto-temporal horn ratio (FTHR) is used as a marker of ventricular dilation and can be a standardized tool to direct the timing of neurosurgical intervention. Our study determined a pre-operative FTHR measurement threshold to predict short- and long-term outcomes.
METHODS: This is a retrospective cohort study of premature infants with severe intraventricular hemorrhage (IVH) who developed PHVD requiring neurosurgical intervention and were treated in a level IV NICU between 2012 and 2019. Receiver operating characteristic (ROC) curve and area under the curve (AUC) analyses were performed to evaluate the accuracy of pre-operative FTHR for predicting developmental delay. In-hospital outcomes and developmental assessments were analyzed.
RESULTS: We reviewed 121 charts of infants with IVH and identified 43 infants with PHVD who required neurosurgical intervention. We found FTHR measurements were an excellent predictor of cognitive and motor delay with an AUC of 0.89 and 0.88, respectively. An average pre-operative FTHR of ≥ 0.67 was also associated with worse lung and feeding outcomes. There was excellent inter-observer reliability of individual components of FTHR measurements.
CONCLUSIONS: Early intervention for PHVD is ideal but not always practical. Identification of ventricular size thresholds associated with better outcomes is needed to direct timing of neurosurgical intervention.
Author List
Serebin M, Zhang J, Yan K, Cabacungan E, Deshmukh T, Maheshwari M, Foy A, Cohen SAuthors
Erwin Cabacungan MD Associate Professor in the Pediatrics department at Medical College of WisconsinSusan Cohen MD Professor in the Pediatrics department at Medical College of Wisconsin
Andrew Foy MD Adjunct Associate Professor in the Neurosurgery department at Medical College of Wisconsin
Mohit Maheshwari MD Professor in the Radiology department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Cerebral HemorrhageCerebral Ventricles
Cohort Studies
Developmental Disabilities
Dilatation, Pathologic
Female
Humans
Infant
Infant, Newborn
Infant, Premature
Male
Neurosurgical Procedures
Retrospective Studies
Treatment Outcome
