Treatment thresholds for post-haemorrhagic ventricular dilatation

Two articles relate to thresholds for intervention in cases of intraventricular haemorrhage complicated by post-haemorrhagic ventricular dilatation. In a study of 17 infants Klebermass-Schrehof and colleagues measured flash visual evoked potentials (fVEP's) and amplitude integrated encephalography (aEEG) weekly and then twice weekly when the ventricular index reached the 97th centile of Levene. In all cases fVEP latency increased and in most cases aEEG became suppressed with increasing dilatation. The changes were observed before clinical signs of raised intracranial pressure were present and before the ventricular index reached the 97th centile plus 4 mm. The authors suggest that functional measures should be included in the clinical management because anatomic measures of dilatation alone may not provide enough information. Both measures normalised soon after therapeutic intervention. The study …