{"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":1791460714562,"version":"4.3.4"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2007,1,2]],"date-time":"2007-01-02T00:00:00Z","timestamp":1167696000000},"content-version":"vor","delay-in-days":1796,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2002,2]]},"abstract":"<jats:p>Posthaemorrhagic ventricular dilatation (PHVD) in very preterm infants carries a poor prognosis. As earlier studies have failed to show a benefit of early intervention, it is recommended that PHVD be first treated when head circumference is rapidly increasing and\/or when symptoms of raised intracranial pressure develop. Infants with PHVD, admitted to 5 of the 10 Dutch neonatal intensive care units were studied retrospectively, to investigate whether there was a difference in the time of onset of treatment of PHVD and, if so, whether this was associated with a difference in the requirement of a ventriculo\u2010peritoneal (VP) shunt and\/or neurodevelopmental outcome. The surviving infants with a gestational age \u226434 wk, born between 1992 and 1996, diagnosed as having a grade III haemorrhage according to Papile on cranial ultrasound and who developed PHVD were included in the study. PHVD was defined as a ventricular index (VI) exceeding the 97th percentile according to Levene (1981), and severe PHVD as a VI crossing the p 97 + 4 mm line. Ninety\u2010five infants met the entry criteria. Intervention was not deemed necessary in 22 infants, because of lack of progression. In 31 infants lumbar punctures (LP) were done before the p 97 + 4 mm line was crossed (<jats:italic>early intervention<\/jats:italic>). In 20\/31 infants, stabilization occurred. In 9 a subcutaneous reservoir was placed, with subsequent stabilization in 6. In 5\/31 infants a VP shunt was eventually inserted. In 42 infants treatment was started once the p 97 + 4 mm line was crossed (<jats:italic>late intervention<\/jats:italic>). In 30 infants LPs were performed and in 17 of these a VP shunt was eventually inserted. In 11 infants a subcutaneous reservoir was immediately inserted and in 8 of these infants a VP shunt was needed. In one infant a VP shunt was immediately inserted, without any other form of treatment. Infants with late intervention crossed the p 97+ 4 mm earlier (p 0.03) and needed a shunt (26\/42; 62%) more often than those with early intervention (5\/31; 16%). Early LP was associated with a strongly reduced risk of VP\u2010shunting (odds ratio = 0.22, 95% confidence interval: 0.08\u20130.62). The number of infants who developed a moderate or severe handicap was also higher (11\/42; 26%) in the late intervention group, compared with those not requiring any intervention (3\/22; 14%) or treated early (5\/31; 16%).<\/jats:p><jats:p> <jats:italic>Conclusion<\/jats:italic>: In this retrospective study, infants receiving late intervention required shunt insertion significantly more often than those treated early. A randomized prospective intervention study, comparing early and late drainage, is required to further assess the role of earlier intervention.<\/jats:p>","DOI":"10.1111\/j.1651-2227.2002.tb01697.x","type":"journal-article","created":{"date-parts":[[2010,8,7]],"date-time":"2010-08-07T03:17:15Z","timestamp":1281151035000},"page":"212-217","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":144,"title":["Early versus late treatment of posthaemorrhagic ventricular dilatation: results of a retrospective study from five neonatal intensive care units in The Netherlands"],"prefix":"10.1111","volume":"91","author":[{"given":"LS","family":"de Vries","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"KD","family":"Liem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"van 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