{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T03:30:24Z","timestamp":1793331024104,"version":"4.5.0"},"reference-count":74,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>This study investigated neurodevelopmental outcomes in preterm neonates with posthemorrhagic hydrocephalus (PHH), focusing on the comparative effectiveness of temporary and permanent CSF diversion strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This multicenter prospective observational cohort study (2012\u20132021) involved preterm infants diagnosed with PHH who underwent either initial permanent or temporary CSF diversion. Patients were assessed using the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III), at 15\u201330 months and, when possible, at 36\u201342 months of corrected age. Statistical analyses included univariable and multivariable regression models to examine the associations between BSID-III scores and various treatment and patient factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Among 106 patients, 15 (14%) underwent initial permanent CSF diversion, while 91 (86%) received temporary diversion. Patients who underwent permanent diversion had lower cognitive scores (58.2 \u00b1 5.7) compared to those temporized (69.0 \u00b1 15.9) (p = 0.01). Temporized patients who later required conversion to permanent diversion demonstrated poorer composite (66.6 \u00b1 18.0 vs 79.9 \u00b1 18.8, p = 0.02), expressive (4.6 \u00b1 3.2 vs 7.0 \u00b1 3.7, p = 0.03), and receptive (4.2 \u00b1 3.3 vs 6.1 \u00b1 3.0, p = 0.04) language scores compared to those weaned from temporary CSF diversion. No significant difference in outcomes was observed between patients temporized with a ventriculosubgaleal shunt versus a ventricular reservoir. Ventricle size at the time of initial CSF diversion was not associated with BSID-III scores. However, univariable analysis showed that a larger ventricle size at the time of conversion to permanent diversion was associated with lower neurodevelopmental scores across all domains. Multivariate analysis, adjusting for intraventricular hemorrhage (IVH) grade, complex chronic conditions, and postmenstrual age, revealed that larger ventricle size at the time of conversion correlated negatively with composite motor (effect size \u22120.47, CI \u22120.82 to \u22120.11, p = 0.01) and fine motor (\u22120.08, CI \u22120.15 to \u22120.01, p = 0.03) scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>This study suggested that the choice between permanent and temporary CSF diversion as initial treatments may affect neurodevelopmental outcomes in preterm neonates with PHH, which are influenced by IVH severity and timing of intervention. The findings support early temporization and avoiding delays to optimize permanent shunting. Monitoring ventricular size closely during this phase is critical, as larger ventricular size at the time of conversion is associated with poorer outcomes. These results highlight the necessity for adapting treatment strategies on the basis of individual patient characteristics, responses, and progress in managing PHH.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2024.10.peds24257","type":"journal-article","created":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T21:21:03Z","timestamp":1738358463000},"page":"315-326","source":"Crossref","is-referenced-by-count":7,"title":["Neurodevelopmental outcomes of permanent and temporary CSF diversion in posthemorrhagic hydrocephalus: a Hydrocephalus Clinical Research Network study"],"prefix":"10.3171","volume":"35","author":[{"given":"Albert M.","family":"Isaacs","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Nationwide Children\u2019s Hospital, Columbus, Ohio;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chevis N.","family":"Shannon","sequence":"additional","affiliation":[{"name":"Section of Pediatric Neurosurgery, Division of Neurosurgery, Children\u2019s Hospital of Alabama, University of Alabama\u2013Birmingham, Alabama;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel R.","family":"Browd","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Washington, Seattle Children\u2019s Hospital, Seattle, Washington;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason S.","family":"Hauptman","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Washington, Seattle Children\u2019s Hospital, Seattle, Washington;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Holubkov","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Utah, Salt Lake City, Utah;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hailey","family":"Jensen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Utah, Salt Lake City, Utah;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhaya V.","family":"Kulkarni","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Hospital for Sick Children, University of Toronto, Ontario, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick J.","family":"McDonald","sequence":"additional","affiliation":[{"name":"Section of Neurosurgery, Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael M.","family":"McDowell","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Children\u2019s Hospital of Pittsburgh, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert P.","family":"Naftel","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nichol","family":"Nunn","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Utah, Salt Lake City, Utah;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Pindrik","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nationwide Children\u2019s Hospital, Columbus, Ohio;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian F.","family":"Pollack","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Children\u2019s Hospital of Pittsburgh, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron","family":"Reeder","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Utah, Salt Lake City, Utah;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay","family":"Riva-Cambrin","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, University of Calgary, Alberta, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Curtis J.","family":"Rozzelle","sequence":"additional","affiliation":[{"name":"Section of Pediatric Neurosurgery, Division of Neurosurgery, Children\u2019s Hospital of Alabama, University of Alabama\u2013Birmingham, Alabama;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon G.","family":"Rocque","sequence":"additional","affiliation":[{"name":"Section of Pediatric Neurosurgery, Division of Neurosurgery, Children\u2019s Hospital of Alabama, University of Alabama\u2013Birmingham, Alabama;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer M.","family":"Strahle","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, St. Louis Children\u2019s Hospital, Washington University in St. Louis, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mandeep S.","family":"Tamber","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Neurosurgery, British Columbia Children\u2019s Hospital, University of British Columbia, Vancouver, British Columbia, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William E.","family":"Whitehead","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Department of Neurosurgery, Texas Children\u2019s Hospital, Baylor College of Medicine, Houston, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John R. W.","family":"Kestle","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David D.","family":"Limbrick","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Virginia Commonwealth University, Richmond, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John C.","family":"Wellons","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"5","key":"b1","series-title":"J Neurosurg Pediatr","first-page":"473","article-title":"Center effect and other factors influencing temporization and shunting of cerebrospinal fluid in preterm infants with intraventricular hemorrhage","volume":"9","author":"Riva-Cambrin J","year":"2012","unstructured":"Riva-Cambrin J, Shannon CN, Holubkov R,  Center effect and other factors influencing temporization and shunting of cerebrospinal fluid in preterm infants with intraventricular hemorrhage. 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