Neonatal Medicine

The Korean Society of Neonatology (대한신생아학회)
권호 표지

Management of Posthemorrhagic Hydrocephalus in an Extremely Low Birth Weight Infant with an Ommaya reservoir: A Case Report

Ommaya reservoir로 관리한 초극소저출생 체중아의 출혈 후 수두증 1례

  • Cho, Hye-Jung (Department of Pediatrics, Gachon University of Medicine and Science, Gil Hospital) ;
  • Son, Dong-Woo (Department of Pediatrics, Gachon University of Medicine and Science, Gil Hospital) ;
  • Shim, So-Yeon (Department of Pediatrics, Gachon University of Medicine and Science, Gil Hospital) ;
  • Kim, Eun-Young (Department of Neurosurgery, Gachon University of Medicine and Science, Gil Hospital) ;
  • Kim, Seung-Ki (Department of Neurosurgery, Seoul National University College of Medicine) ;
  • Kim, Han-Suk (Department of Pediatrics, Seoul National University College of Medicine) ;
  • Jeon, In-Sang (Department of Pediatrics, Gachon University of Medicine and Science, Gil Hospital)
  • 조혜정 (가천의과대학교 길병원 소아과학교실) ;
  • 손동우 (가천의과대학교 길병원 소아과학교실) ;
  • 심소연 (가천의과대학교 길병원 소아과학교실) ;
  • 김은영 (가천의과대학교 길병원 신경외과학교실) ;
  • 김승기 (서울대학교 의과대학 신경외과학교실) ;
  • 김한석 (서울대학교 의과대학 소아과학교실) ;
  • 전인상 (가천의과대학교 길병원 소아과학교실)
  • Published : 2009.11.30

⟨ Previous Next ⟩

Abstract

Posthemorrhagic hydrocephalus is a major problem in premature infants. We describe our experience with a neonate that was an extremely low birth weight infant with posthemorrhagic hydrocephalus, who was treated by repeated ventricular drainage through an Ommaya reservoir for more than two months until the placement of a ventriculoperitoneal shunt was possible. The Ommaya reservoir served as a bridge to definitive treatment. The patient required sodium supplements due to excessive salt loss from the repeated ventricular drainage procedures. Regular measurement of serum electrolytes in any infant requiring serial ventricular drainage is recommended.

출혈 후 수두증은 미숙아에서 발생하는 주요한 합병증 중 하나이다. 저자들은 출혈 후 수두증을 가진 초극소 저출생체중아에게 Ommaya reservoir를 삽입하여 2개월 이상 반복적인 뇌척수액 배액을 시행하였다. Ommaya reservoir는 출혈 후 수두증을 가진 초극소 저출생체중아에서 뇌실복강지름술이 가능한 시기까지 수두증 관리에 유용한 방법으로 생각된다. 같은 환아에서 치료 중 뇌척수액 배액에 동반된 저나트륨혈증이 발견되어 나트륨 투여로 치료하였던 1례를 보고한다. 되풀이되는 뇌척수액 배액이 필요한 영아에서 정기적 혈중 나트륨농도 측정이 필요할 것으로 생각된다.

Keywords

References

  1. Peretta P, Ragazzi P, Carlino CF, Gaglini P, Cinalli G. The role of Ornmaya reservoir and endoscopic third ventriculostomy in the management of post-hemorrhagic hydrocephalus of prematurity. Childs Nerv Syst 2007;23:765-71. https://doi.org/10.1007/s00381-006-0291-4
  2. Shooman D, Portess H, Sparrow O. A review of the current treatment methods for posthaemorrhagic hydrocephalus of infants. Cerebrospinal Fluid Res 2009;6:1. https://doi.org/10.1186/1743-8454-6-1
  3. Richard E, Cinalli G, Assis D, Pierre-Kahn A, Lacaze-Masmonteil T. Treatment of post-haemorrhage ventricular dilatation with an Ommaya's reservoir: management and outcome of 64 preterm infants. Childs Nerv Syst 2001;17:334-40. https://doi.org/10.1007/s003810000418
  4. Lin ZL, Yu B, Liang ZQ, Chen XW, Liu JQ, Chen SQ, et al. Role of Ornmaya reservoir in the management of neonates with post-hemorrhagic hydrocephalus. Zhonghua Er Ke Za Zhi 2009;47:140-5.
  5. Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. J Pediatr 1978;92:529-34. https://doi.org/10.1016/S0022-3476(78)80282-0
  6. Vertinsky AT, Barnes PD. Macrocephaly, increased intracranial pressure, and hydrocephalus in the infant and young child. Top Magn Reson Imaging 2007;18:31-51. https://doi.org/10.1097/RMR.0b013e3180d0a753
  7. Persson EK, Anderson S, Wiklund LM, Uvebrant P. Hydrocephalus in children born in 1999-2002: epidemiology, outcome and ophthalmological findings. Childs Nerv Syst 2007;23:1111-8. https://doi.org/10.1007/s00381-007-0324-7
  8. de Vries LS, Liem KD, van Dijk K, Smit BJ, Sie L, Rademaker KJ, et al. Early versus late treatment of posthaemorrhagic ventricular dilatation: results of a retrospective study from five neonatal intensive care units in The Netherlands. Acta Paediatr 2002;91:212-7. https://doi.org/10.1080/080352502317285234
  9. Uejima T, Suresh S. Ommaya and McComb reservoir placement in infants: can this be done with regional anesthesia? Paediatr Anaesth 2008;18:909-11. https://doi.org/10.1111/j.1460-9592.2008.02565.x
  10. Cornips E, Van Calenbergh F, Plets C, Devlieger H, Casaer P. Use of external drainage for posthemorrhagic hydrocephalus in very low birth weight premature infants. Childs Nerv Syst 1997;13:369-74. https://doi.org/10.1007/s003810050102
  11. Dickerman RD, Eisenberg MB. Preassembled method for insertion of Ommaya reservoir. J Surg Oncol 2005;89:36-8. https://doi.org/10.1002/jso.20174
  12. Willis B, Javalkar V, Vannemreddy P, Caldito G, Matsuyama J, Guthikonda B, et al. Ventricular reservoirs and ventriculoperitoneal shunts for premature infants with posthemorrhagic hydrocephalus: an institutional experience. J Neurosurg Pediatr 2009;3:94-100. https://doi.org/10.3171/2008.11.PEDS0827
  13. Dinndorf PA, Bleyer WA. Management of infectious complications of intraventricular reservoirs in cancer patients: low incidence and successful treatment without reservoir removal. Cancer Drug Deliv 1987;4:105-17. https://doi.org/10.1089/cdd.1987.4.105
  14. Chamberlain MC. Neoplastic meningitis. J Clin Oncol 2005;23:3605-13. https://doi.org/10.1200/JCO.2005.01.131
  15. MacMahon P, Cooke RW. Hyponatraemia caused by repeated cerebrospinal fluid drainage in post haemorrhagic hydrocephalus. Arch Dis Child 1983;58:385-6. https://doi.org/10.1136/adc.58.5.385
  16. Caglar MK, Deniz FE, Ozer I, Sezer T, Senayli A. An unusual cause of hyponatremia: ventricular drainage. Neurol India 2006;54:109. https://doi.org/10.4103/0028-3886.25145