Acquired aqueductal stenosis in preterm infants: an indication for neuroendoscopic third ventriculostomy

Abstract Object: The object of this
study is to demonstrate the delayed
occurrence of aqueductal stenosis in
preterm infants who have suffered
from intraventricular hemorrhage
(IVH) and to try to explain the
mechanisms of this stenosis.
Method: From January 1996 to June
2002, 1,046 premature infants were
admitted to our institution. Thirty-six
neonates suffered from grade 3 or
4 intraventricular hemorrhage
(Papile grading), of whom 16 died.
Twenty patients survived and a ventriculoperitoneal
shunt was inserted
in 7 infants. Four patients underwent
a neuroendoscopic third ventriculostomy.
Follow-up was carried out,
twice a month during the first
2 months and subsequently twice a
year. Conclusion: In 2 children NTV
was an effective treatment for hydrocephalus
with an average follow-up
of 29 months. The specific pattern
concerning these patients is the long
delay before obstructive hydrocephalus
and the visualization of de novo
obstruction with MRI. The biological
explanation must be investigated.
Keywords Premature newborn ·
Intraventricular hemorrhage ·
Hydrocephalus · Neuroendoscopy ·
Aqueductal stenosis · Acquired
obstructive hydrocephalus ·
Transforming growth factor b1