{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T11:58:34Z","timestamp":1791460714608,"version":"4.3.4"},"reference-count":8,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2023,11,12]],"date-time":"2023-11-12T00:00:00Z","timestamp":1699747200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,11,12]],"date-time":"2023-11-12T00:00:00Z","timestamp":1699747200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Childs Nerv Syst"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>Neuro-endoscopic lavage (NEL) is an increasingly popular intervention for intraventricular haemorrhage (IVH) and post-haemorrhagic hydrocephalus (PHH), with considerable variation in technique dependent on clinician and clinical circumstances. Whilst efforts to standardise the technique are ongoing, this work describes a tertiary centre experience utilising NEL, highlighting potential caveats to standardisation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A retrospective review of electronic case notes for patients undergoing temporising surgical intervention for IVH between 2012 and 2021 at our centre was performed. Data collected included (i) gestational age, (ii) aetiology of hydrocephalus, (iii) age at time of intervention, (iv) intervention performed, (v) need for permanent CSF diversion, (vi) \u2018surgical burden\u2019, i.e. number of procedures following primary intervention, and (vii) wound failure and infection rate. Data was handled in Microsoft Excel and statistical analysis SPSS v27.0<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>49 neonates (<jats:italic>n<\/jats:italic>\u2009=\u200925 males) were included. Overall mean gestational age was 27 weeks and at intervention 35\u2009+\u20093 weeks. IVH was the predominant cause of hydrocephalus (93.8%) and primary surgical interventions included insertion of a ventriculosubgaleal shunt (VSGS) in <jats:italic>n<\/jats:italic>\u2009=\u200941 (83.6%) patients, NEL in <jats:italic>n<\/jats:italic>\u2009=\u20096 (12.2%) patients and insertion of an EVD in <jats:italic>n<\/jats:italic>\u2009=\u20092 (4.1%). <jats:italic>N<\/jats:italic>\u2009=\u20099 (18.4%) patients underwent NEL at some point during the time interval reviewed; n\u2009=\u20094 (8.2%) received NEL monotherapy and <jats:italic>n<\/jats:italic>\u2009=\u20095 (10.2%) also received a VSGS. Rate of conversion to definitive CSF diversion between NEL (<jats:italic>n<\/jats:italic>\u2009=\u20098, 88.9%) and VSGS cohorts (<jats:italic>n<\/jats:italic>\u2009=\u200937, 92.5%) was not significantly different (<jats:italic>p<\/jats:italic>\u2009=\u20090.57), nor between NEL alone (<jats:italic>n<\/jats:italic>\u2009=\u20093, 75%) and NEL\u2009+\u2009VSGS (<jats:italic>n<\/jats:italic>\u2009=\u20095, 100%) (<jats:italic>p<\/jats:italic>\u2009=\u20090.44). None of the patients that underwent NEL monotherapy had any wound issues or CNS infection as a result of the initial intervention, compared to <jats:italic>n<\/jats:italic>\u2009=\u20093 (60%) of those that underwent NEL and implantation of VSGS (<jats:italic>p<\/jats:italic>\u2009=\u20090.1).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Both NEL and VSGS are effective in temporising hydrocephalus in neonates, occasionally offering a definitive solution in and of themselves. The benefit of dual therapy however remains to be seen, with the addition of VSGS potentially increasing the risk of wound failure in an already vulnerable cohort.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00381-023-06214-6","type":"journal-article","created":{"date-parts":[[2023,11,12]],"date-time":"2023-11-12T15:01:40Z","timestamp":1699801300000},"page":"665-671","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["A tailored approach to the management of post-haemorrhagic hydrocephalus"],"prefix":"10.1007","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9529-5072","authenticated-orcid":false,"given":"Benjamin J.","family":"Hall","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John C.","family":"Duddy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katerina","family":"Apostolopoulou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedetta","family":"Pettorini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,11,12]]},"reference":[{"key":"6214_CR1","unstructured":"Pettorini B, Keh R, Ellenbogen J, Williams D, Zebian B (2014) Intraventricular haemorrhage in prematurity. Infant 10(6):186\u2013190"},{"issue":"5","key":"6214_CR2","doi-asserted-by":"publisher","first-page":"466","DOI":"10.1136\/archdischild-2019-318231","volume":"105","author":"K Luyt","year":"2020","unstructured":"Luyt K, Jary SL, Lea CL, Young GJ, Odd DE, Miller HE et al (2020) Drainage, irrigation and fibrinolytic therapy (DRIFT) for posthaemorrhagic ventricular dilatation: 10-year follow-up of a randomised controlled trial. Arch Dis Child Fetal Neonatal Ed 105(5):466\u2013473","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"2","key":"6214_CR3","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1007\/s00381-021-05400-8","volume":"38","author":"V Kandula","year":"2022","unstructured":"Kandula V, Mohammad LM, Thirunavu V, LoPresti M, Beestrum M, Lai GY et al (2022) The role of blood product removal in intraventricular hemorrhage of prematurity: a meta-analysis of the clinical evidence. Childs Nerv Syst 38(2):239\u2013252","journal-title":"Childs Nerv Syst"},{"key":"6214_CR4","doi-asserted-by":"crossref","unstructured":"DOLPHIN-UK Collaborators, Aquilina K, Mallucci C, Chari A, Mediratta S, Sivakumar G et al (2022) A standardised protocol for neuro-endoscopic lavage for post-haemorrhagic ventricular dilatation: A Delphi consensus approach. Childs Nerv Syst 38(11):2181\u20137","DOI":"10.1007\/s00381-022-05632-2"},{"issue":"1","key":"6214_CR5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1203\/PDR.0b013e3181c1b176","volume":"67","author":"P Ballabh","year":"2010","unstructured":"Ballabh P (2010) Intraventricular hemorrhage in premature infants: mechanism of disease. Pediatr Res 67(1):1\u20138","journal-title":"Pediatr Res"},{"issue":"8","key":"6214_CR6","doi-asserted-by":"publisher","first-page":"238","DOI":"10.3389\/fped.2020.00238","volume":"23","author":"L Mahoney","year":"2020","unstructured":"Mahoney L, Luyt K, Harding D, Odd D (2020) Treatment for post-hemorrhagic ventricular dilatation: a multiple-treatment meta-analysis. Front Pediatr 23(8):238","journal-title":"Front Pediatr"},{"key":"6214_CR7","doi-asserted-by":"crossref","unstructured":"Pinto C, Malik P, Desai R, Shelar V, Bekina-Sreenivasan D, Satnarine TA et al (2021) Post-Hemorrhagic hydrocephalus and outcomes amongst neonates with intraventricular hemorrhage: a systematic review and pooled analysis. Cureus [cited 2023 Sep 20]. Available from: https:\/\/www.cureus.com\/articles\/48445-post-hemorrhagic-hydrocephalus-and-outcomes-amongst-neonates-with-intraventricular-hemorrhage-a-systematic-review-and-pooled-analysis","DOI":"10.7759\/cureus.18877"},{"issue":"2","key":"6214_CR8","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1007\/s00381-014-2596-z","volume":"31","author":"SHA Akbari","year":"2015","unstructured":"Akbari SHA, Holekamp TF, Murphy TM, Mercer D, Leonard JR, Smyth MD et al (2015) Surgical management of complex multiloculated hydrocephalus in infants and children. Childs Nerv Syst 31(2):243\u2013249","journal-title":"Childs Nerv Syst"}],"container-title":["Child's Nervous System"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00381-023-06214-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00381-023-06214-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00381-023-06214-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T11:12:55Z","timestamp":1708686775000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00381-023-06214-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,12]]},"references-count":8,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,3]]}},"alternative-id":["6214"],"URL":"https:\/\/doi.org\/10.1007\/s00381-023-06214-6","relation":{},"ISSN":["0256-7040","1433-0350"],"issn-type":[{"value":"0256-7040","type":"print"},{"value":"1433-0350","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,12]]},"assertion":[{"value":"22 September 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 November 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 November 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Audit approval was obtained from the Alder Hey Neurosurgical department clinical team prior to commencement of the study. Ethical approval for this study was not required in view of the retrospective nature of the study, and all the procedures being performed were part of the routine care.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"All data collected and used in the study was fully anonymised prior to analysis and submission for publication.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"All data collected and used in the study was fully anonymised prior to analysis and submission for publication.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors have no relevant financial or non-financial interests to disclose.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}