The treatment of patients with posthemorrhagic hydrocephalus

Abstract

The article discusses the possible causes of polycystic posthemorrhagic ventriculomegaly in infants, as well as predictors of this pathological process. When choosing a treatment method the doctor shall take into account not only the etiology of the disease, but also age parameters, concomitant pathology. An important aspect in the approach to the treatment of polycystic posthemorrhagic multilevel hydrocephalus includes the determination of the biomechanical properties of the craniospinal system, especially the compliance of the brain and resorption of cerebrospinal fluid. Particular attention is paid to the timely correction of complications, including the analysis of inflammatory changes markers in the craniospinal system, which serve as predictors of the outcome of cerebrospinal fluid resorption. The authors also noted that the violation of the cerebrospinal fluid outflow from the cranial cavity in children may depend on a large number of «extracerebral» factors. They consider the stages of neurosurgical care to patients in this group on a clinical example. This example and literature data demonstrate that children with age develop changes not only in the craniospinal segment, which is responsible for the transformation of free fluid, but also in the extracranial cavities. Thus, we are able to recommend an integrated approach for the management of newborns with intracranial hemorrhage, complicated by posthemorrhagic hyporesorbent and occlusive hydrocephalus, with the justification of the optimal neurosurgical tactics for managing drainage-dependent patients, the course of the disease in which is accompanied by a multicomponent inflammatory syndrome.