Skip to main content
Log in

Progressive posthemorrhagic hydrocephalus leads to changes of amplitude-integrated EEG activity in preterm infants

  • Original Paper
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

Aim

Intraventricular hemorrhage (IVH) is the most common cause of brain lesions in preterm infants. Among infants with IVH about 35% develop posthemorrhagic hydrocephalus (PPH) which may lead to secondary injury. Therapeutic interventions to reduce the increased intracranial pressure are invasive and carry a high risk of complications. Amplitude-integrated EEG (aEEG) allows continuous neurophysiological surveillance and may help in defining the optimal timing for intervention in infants with progressive PHH. In this report we show, for the first time, a change in aEEG activity in two preterm infants with PHH.

Methods

Cerebral activity was continuously monitored by aEEG provided by the Cerebral Function Monitor (Lectromed, UK) in two preterm infants with PPH.

Results

With increasing ventricular width, aEEG showed an increased discontinuity without distinguishable sleep-wake cycling in both infants. One infant showed an abrupt onset of a nearly isoelectric pattern without any change in clinical condition. Clinical signs of increased intracranial pressure developed 6–12 h later in both children. In one patient, aEEG activity returned to normal after successful shunting and reduction of intracranial pressure.

Conclusion

Continuous neurophysiological monitoring by aEEG may be of value in the diagnostic and therapeutic management of preterm infants with progressive PHH.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. Volpe JJ (1989) Intraventricular hemorrhage and brain injury in the premature infant: diagnosis, prognosis and prevention. Clin Perinatol 16:387–411

    CAS  PubMed  Google Scholar 

  2. Volpe JJ (2001) Neurology of the newborn, 4th edn. Saunders, Philadelphia

  3. Del Bigio M, Bruni J (1988) Periventricular pathology in hydrocephalic rabbits before and after shunting. Acta Neuropathol 77:186–195

    PubMed  Google Scholar 

  4. Hale PM, Mcallister JP 2nd, Katz SD, Wright LC, Lovely TJ, Miller DW, Wolfson BJ, Salotto BJ, Shroff DV (1992) Improvement of cortical morphology in infantile hydrocephalic animals after ventriculoperitoneal shunt placement. Neurosurgery 31:1085–1096

    CAS  PubMed  Google Scholar 

  5. McAllister JP 2nd, Maugans T, Shah M, Truex RC Jr (1985) Neuronal effects of experimentally induced hydrocephalus in newborn rats. J Neurosurg 63:776

    PubMed  Google Scholar 

  6. Ventriculomegaly Trial Group (1990) Randomised trial of early taping in neonatal posthermorrhagic ventricular dilatation. Arch Dis Child 65:3–10

    PubMed  Google Scholar 

  7. Weninger M, Salzer H, Pollak A, Rosenkranz M, Vorkapic P, Korn A, Lesigang C (1992) External ventricular drainage for treatment of rapidly progressive posthemorrhagic hydrocephalus. Neurosurgery 31:52–58

    CAS  PubMed  Google Scholar 

  8. McComb JG, Ramos AD, Platzker AC, Henderson DJ, Segall HD (1983) Management of hydrocephalus secondary to intraventricular hemorrhage in the preterm infant with a subcutaneous ventricular reservoir. Neurosurgery 13:295–300

    CAS  PubMed  Google Scholar 

  9. Blount J, Campbell J, Haines S (1993) Complications in ventricular cerebrospinal fluid shunting. Neurosurg Clin North Am 4:633–656

    CAS  Google Scholar 

  10. Levene MI (1981) Measurement of the growth of the lateral ventricles in preterm infants with real-time ultrasound. Arch Dis Child 56:900–904

    CAS  PubMed  Google Scholar 

  11. Klebermass K, Kuhle S, Kohlhauser-Vollmuth C, Pollak A, Weninger M (2001) Evaluation of the cerebral function monitor as a tool for neurophysiological surveillance in neonatal intensive care patients. Childs Nerv Syst 17:544–550

    Article  CAS  PubMed  Google Scholar 

  12. Maynard DE, Prior P, Scott DF (1969) Device for continuous monitoring of cerebral activity in resuscitated patients. BJM 11:545–546

    Google Scholar 

  13. Hellström-Westas L, Rosén I, Svenningsen NW (1991) Cerebral function monitoring during the first week of life in extremely small low birth weight (ELBSW) infants. Neuropediatrics 22:27–32

    PubMed  Google Scholar 

  14. Kuhle S, Klebermass K, Olischar M, Hulek M, Prusa AR, Kohlhauser C, Birnbacher R, Weninger M (2001) Sleep-wake-cycles in preterm infants below 30 weeks of gestational age. Preliminary results of a prospective amplitude-integrated EEG study. Wien Klin Wochenschr 113:219–223

    CAS  PubMed  Google Scholar 

  15. Rosenberg G, Saland L, Kyner W (1983) Pathophysiology of periventricular tissue changes with raised CSF pressure in cats. J Neurosurg 59:606–611

    CAS  PubMed  Google Scholar 

  16. Del Bigio M, Kanfer J, Zhang Y (1997) Myelination delay in the cerebral white matter of immature rats with kaolin-induced hydrocephalus is reversible. J Neuropathol Exp Neurol 56:1053–1066

    PubMed  Google Scholar 

  17. Resch B, Gedermann A, Maurer U, Ritschl E, Müller W (1996) Neurodevelopmental outcome of hydrocephalus following intra-/periventricular hemorrhage in preterm infants: short and long-term results. Childs Nerv Syst 12:27–33

    CAS  PubMed  Google Scholar 

  18. De Vries LS, Pierrat V, Minami T, Smet M, Caesar P (1990) The role of short latency somatosensory evoked responses in infants with rapidly progressive ventricular dilation. Neuropediatrics 21:136–139

    PubMed  Google Scholar 

  19. Ventriculomegaly Trial Group (1994) Randomised trial of early tapping in neonatal posthemorrhagic ventricular dilation: results at 30 months. Arch Dis Child 70:F129–F136

    Google Scholar 

  20. Robles P, Poblano A, Hernandez G, Ibarra J, Guzman I, Sosa J (2002) Cortical, brainstem and autonomic nervous system dysfunction in infants with post-hemorrhagic hydrocephalus. Rev Invest Clin 54:133–138

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to K. Klebermass.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Olischar, M., Klebermass, K., Kuhle, S. et al. Progressive posthemorrhagic hydrocephalus leads to changes of amplitude-integrated EEG activity in preterm infants. Childs Nerv Syst 20, 41–45 (2004). https://doi.org/10.1007/s00381-003-0809-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-003-0809-y

Keywords

Navigation