{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T23:41:56Z","timestamp":1790725316813,"version":"4.1.0"},"reference-count":20,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2016,11]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Intraventricular hemorrhage (IVH) is a complication of prematurity often associated with ventricular dilation, which may resolve over time or progress to posthemorrhagic hydrocephalus (PHH). This study investigated anatomical factors that could predispose infants with IVH to PHH.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n The authors analyzed a cohort of premature infants diagnosed with Grade III or IV IVH between 2004 and 2014. Using existing ultrasound and MR images, the CSF obstruction pattern, skull shape, and brain\/skull ratios were determined, comparing children with PHH to those with resolved ventricular dilation (RVD), and comparing both groups to a set of healthy controls.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Among 110 premature infants with Grade III or IV IVH, 65 (59%) developed PHH. Infants with PHH had more severe ventricular dilation compared with those with RVD, although ranges overlapped. Intraventricular CSF obstruction was observed in 36 (86%) of 42 infants with PHH and 0 (0%) of 18 with RVD (p < 0.001). The distribution of skull shapes in infants with PHH was similar to those with RVD, although markedly different from controls. No significant differences in supratentorial brain\/skull ratio were observed; however, the mean infratentorial brain\/skull ratio of infants with PHH was 5% greater (more crowded) than controls (p = 0.006), whereas the mean infratentorial brain\/skull ratio of infants with RVD was 8% smaller (less crowded) than controls (p = 0.004).<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Among premature infants with IVH, intraventricular obstruction and infratentorial crowding are strongly associated with PHH, further underscoring the need for brain MRI in surgical planning. Prospective studies are required to determine which factors are cause and which are consequence, and which can be used to predict the need for surgical intervention.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2016.8.focus16241","type":"journal-article","created":{"date-parts":[[2016,11,1]],"date-time":"2016-11-01T03:38:03Z","timestamp":1477971483000},"page":"E5","source":"Crossref","is-referenced-by-count":12,"title":["Anatomical configurations associated with posthemorrhagic hydrocephalus among premature infants with intraventricular hemorrhage"],"prefix":"10.3171","volume":"41","author":[{"given":"Hannah M.","family":"Tully","sequence":"first","affiliation":[{"name":"Departments of Neurology,"},{"name":"Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tara L.","family":"Wenger","sequence":"additional","affiliation":[{"name":"Pediatrics, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter A.","family":"Kukull","sequence":"additional","affiliation":[{"name":"Epidemiology, University of Washington; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Doherty","sequence":"additional","affiliation":[{"name":"Pediatrics, and"},{"name":"Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William B.","family":"Dobyns","sequence":"additional","affiliation":[{"name":"Departments of Neurology,"},{"name":"Pediatrics, and"},{"name":"Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-focus16241","series-title":"Neurosurg Clin N Am","first-page":"631","article-title":"Evolving concepts of cerebrospinal fluid physiology","volume":"12","author":"Bergsneider","year":"2001"},{"key":"b2-focus16241","series-title":"Arch Dis Child Fetal Neonatal Ed","first-page":"F50","article-title":"European perspective on the diagnosis and treatment of posthaemorrhagic ventricular dilatation","volume":"97","author":"Brouwer","year":"2012"},{"key":"b3-focus16241","series-title":"Acta Paediatr","first-page":"1298","article-title":"Ultrasound measurements of the lateral ventricles in neonates: why, how and when? A systematic review","volume":"99","author":"Brouwer","year":"2010"},{"key":"b4-focus16241","series-title":"J Neurosurg Pediatr","first-page":"310","article-title":"Predicting who will benefit from endoscopic third ventriculostomy compared with shunt insertion in childhood hydrocephalus using the ETV Success Score","volume":"6","author":"Kulkarni","year":"2010"},{"issue":"Suppl 1","key":"b5-focus16241","series-title":"J Neurosurg Pediatr","first-page":"8","article-title":"Pediatric hydrocephalus: systematic literature review and evidence-based guidelines. Part 2: Management of posthemorrhagic hydrocephalus in premature infants","volume":"14","author":"Mazzola","year":"2014"},{"key":"b6-focus16241","series-title":"Neurol Res","first-page":"247","article-title":"Cerebrospinal fluid hydrodynamics in type I Chiari malformation","volume":"33","author":"Shaffer","year":"2011"},{"issue":"Suppl 1","key":"b7-focus16241","series-title":"Transl Stroke Res","first-page":"25","article-title":"Mechanisms of hydrocephalus after neonatal and adult intraventricular hemorrhage","volume":"3","author":"Strahle","year":"2012"},{"key":"b8-focus16241","series-title":"J Pediatr","first-page":"366","article-title":"Differential effects of intraventricular hemorrhage and white matter injury on preterm cerebellar growth","volume":"158","author":"Tam","year":"2011"},{"key":"b9-focus16241","series-title":"Eur J Paediatr Neurol","first-page":"487","article-title":"Neurodevelopmental outcome of post-hemorrhagic ventricular dilatation at 12 and 24 months corrected age with high-threshold therapy","volume":"15","author":"van Zanten","year":"2011"},{"key":"b10-focus16241","series-title":"Childs Nerv Syst","first-page":"1063","article-title":"Initial experience with combined endoscopic third ventriculostomy and choroid plexus cauterization for post-hemorrhagic hydrocephalus of prematurity: the importance of prepontine cistern status and the predictive value of FIESTA MRI imaging","volume":"27","author":"Warf","year":"2011"},{"key":"b1-focus16241","series-title":"Neurosurg Clin N Am","first-page":"631","article-title":"Evolving concepts of cerebrospinal fluid physiology","volume":"12","author":"Bergsneider","year":"2001"},{"key":"b2-focus16241","series-title":"Arch Dis Child Fetal Neonatal Ed","first-page":"F50","article-title":"European perspective on the diagnosis and treatment of posthaemorrhagic ventricular dilatation","volume":"97","author":"Brouwer","year":"2012"},{"key":"b3-focus16241","series-title":"Acta Paediatr","first-page":"1298","article-title":"Ultrasound measurements of the lateral ventricles in neonates: why, how and when? 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