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Comment
. 2020 Nov:226:16-27.e3.
doi: 10.1016/j.jpeds.2020.07.079. Epub 2020 Jul 30.

Management of Post-hemorrhagic Ventricular Dilatation in the Infant Born Preterm

Mohamed El-Dib  1 , David D Limbrick Jr  2 , Terrie Inder  3 , Andrew Whitelaw  4 , Abhaya V Kulkarni  5 , Benjamin Warf  6 , Joseph J Volpe  7 , Linda S de Vries  8
Affiliations
Comment

Management of Post-hemorrhagic Ventricular Dilatation in the Infant Born Preterm

Mohamed El-Dib et al. J Pediatr. 2020 Nov.
No abstract available

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1:
Figure 1:. Demonstration of different ventricular measures and ratios
Images from cUS and brain MRI of one-week old boy born at 30 weeks of gestation. A and F= Coronal cUS at level of Foramen of Monro, B= Parasagittal cUS, C= Axial View of T2 MRI. D= Coronal cUS at level of occipital horn E= Coronal View of T2 MRI, VI= Ventricular Index, AHW= Anterior Horn Width, TOD= Thalamo-Occipital Diameter MRI dimensions are in Capital letters= F= bifrontal horn, BP= biparietal, T= bitemporal horn, O =bioccipital horn cUS dimensions are in small letters= f= bifrontal horn, bp= biparietal, t= bitemporal horn, o =bioccipital horn Evans Ratio= F/BP by MRI or f/bp by US Frontal and Temporal Horn Ratio= (F+T/2)/ BP by MRI or (f+t/2)/bp by cUS Frontal and Occipital Horn Ratio (FOHR)= (F+O/2)/BP by MRI or (f+o/2)/bp by cUS
Figure 2:
Figure 2:
Anterior Horn Width in relation to neurodevelopmental outcomes at 18–24 months in 39 preterm infants with PHVD. The maximal size of the AHW in the North American group of the study by Leijser et al, (yellow bar) and the corresponding neurodevelopmental impairments with performance at 60–70 points, contrasts with the results in the ELVIS study with early (red) and late (blue) demonstrating less significant differences in outcomes. It is noteworthy that timing of the “late” intervention arm in ELVIS is much earlier than in the North American sites.
Figure 3;
Figure 3;
online: An illustration of the commonly used temporizing measures for PHVD: A) Ventricular Reservoir (VR), and B) Ventricular Subgaleal Shunt (VSGS)
Figure 4:
Figure 4:. A practical clinical tool to monitor commonly used ventricular measures.
Individual measures can be plotted in mm in the table as well as on the corresponding postmenstrual age in the graph to identify risk zone. VI= Ventricular Index, AHW= Anterior Horn Width, TOD= Thalamo-Occipital Diameter
Figure 5:
Figure 5:. Proposed risk stratification and management of infants with PHVD
See this image and copyright information in PMC

Comment on

References

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