Article Text

Download PDFPDF
Procollagen I C-propeptide in the cerebrospinal fluid of neonates with posthaemorrhagic hydrocephalus
  1. A Heep1,
  2. B Stoffel-Wagner2,
  3. V Soditt3,
  4. C Aring3,
  5. P Groneck3,
  6. P Bartmann1
  1. 1Department of Neonatology, University of Bonn, Germany
  2. 2Department of Clinical Biochemistry, University of Bonn
  3. 3Childrens Hospital of Cologne, Germany
  1. Correspondence to:
    Dr A Heep, Universitaetsklinikum Bonn, Abteilung Neonatologie, Perinatalzentrum, Adenauerallee 119, D-53113 Bonn, Germany;


Background: The pathogenesis of posthaemorrhagic hydrocephalus (PHHC) following intraventricular haemorrhage (IVH) in premature infants includes a fibroproliferative reaction leading to arachnoidal fibrosis, ultimately causing malresorption of cerebrospinal fluid (CSF) at the arachnoid villi.

Aims: To determine whether an increased concentration of the carboxyterminal propeptide of type I procollagen (PICP) in the CSF of neonates after IVH reflects the activation of collagen synthesis preceding the manifestation of PHHC.

Methods: From 20 neonates with PHHC (median birth weight 740 g, median gestational age 25+1 weeks), 52 CSF samples were collected. CSF samples of four neonates (median birth weight 2170 g, median gestational age 32+4 weeks) with congenital non-haemorrhagic hydrocephalus served as controls. PICP was measured by radioimmunoassay.

Results: PICP in CSF taken at the start of external CSF drainage (median day 21, range 17–25 days postnatal age) was significantly increased (median 851.5, range 153.5–1944 μg/l) compared with controls (median 136.1, range 33.8–169.5 μg/l). CSF concentrations of PICP declined until permanent shunt placement (median day 70, range days 41–113).

Conclusion: In neonates who develop PHHC, significant elevation of PICP concentration in the CSF is present 3–4 weeks after IVH. It reflects the increase of local type I collagen turnover, thereby correlating with manifestation of PHHC.

  • PICP
  • procollagen I propeptide
  • posthaemorrhagic hydrocephalus
  • meningeal fibrosis
  • CSF, cerebrospinal fluid
  • IVH, intraventricular haemorrhage
  • PHHC, posthaemorrhagic hydrocephalus
  • PICP, carboxyterminal propeptide of type I procollagen
  • PIIICP, carboxyterminal propeptide of type III procollagen
  • PINP, aminoterminal propeptide of type I procollagen
  • PIIINP, aminoterminal propeptide of type III procollagen
  • SAH, subarachnoid haemorrhage

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


Linked Articles

  • Fantoms
    Ben Stenson