Preterm bebeklerde intraventriküler kanama ve posthemorajik ventriküler dilatasyonun izlemi

Düşük doğum ağırlıklı bebeklerde yaşam şansı artarken, intraventriküler kanama gelişen çok immatür preterm bebek oranında da artış devam etmektedir. Posthemorajik ventriküler dilatasyon preterm bebeklerin intraventriküler kanamalarının en ciddi direkt komplikasyonudur. Küçük birçok kan pıhtısının serebrospinal sıvının dolaşım ve emilimin engellemesi sonucunda gelişir. Yönetimi zordur ve yeni tedavi yaklaşımlarına gereksinim vardır.

Anahtar Kelimeler:

Kanama, Genişleme, patolojik, Prematüre doğum, Süt çocuğu, prematür

The management of intraventricular haemorrhage and posthaemorrhagic ventricular dilatation in the preterm baby

Survival continues to increase in all low birth weight categories, thus the increase in the proportion of most immature preterm infants who develop intraventricular haemorrhage continues. Posthaemorrhagic ventricular dilatation is the most serious direct complication of intraventricular haemorrhage of preterm infants. It results initially from multiple small blood clots throughout the cerebrospinal fluid channels impeding circulation and reabsorption. Management is difficult and new treatment approaches are needed.

Keywords:

Hemorrhage, Dilatation, Pathologic, Premature Birth, Infant, Premature,

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1. Volpe JJ. Brain injury in the premature infant: a review of clinical aspects, neuropathology, and pathogenesis. Semin Pediatr Neurol 1998; 5:135-51.
2. Whitelaw A, Thoresen M, Pople I. Posthaemorrhagic ventricular dilatation. Arch Dis Child Fetal-Neonatal Ed. 2002; 86:72-4.
3. Whitelaw A. Repeated lumbar or ventricular punctures in newborns with intraventricular hemorrhage.Cochrane Database Syst Rev. 2001; CD000216. Review.
4. Ventriculomegaly Trial Group. Randomised trial of early tapping in neonatal posthaemorrhagic ventricular dilatation. Arch Dis Child 1990; 65:3-10.
5. International PHVD Drug Trial Group. International randomised trial of acetazolamide and frusemide in posthaemorrhagic ventricular dilatation. Lancet 1998; 352:433-40.
6. Whitelaw A, Kennedy C, Brion L. Diuretic therapy for newborn infants with post-hemorrhagic ventricular dilatation. In: The Cochrane Library, Issue 2. Oxford: Update Software, 2001.
7. Whitelaw A. We need a new understanding of the circulation of cerebrospinal fluid. Acta Paediatr 1997; 86:133-4.
8. Whitelaw A. Endogenous fibrinolysis in neonatal cerebrospinal fluid. Eur J Pediatr 1993;152: 928-30.
9. Murphy BP, Inder TE, Rooks V, et al. Posthaemorrhagic ventricular dilatation in the premature infant:natural history and predictors of outcome. Arch Dis Child Fetal Neonatal Ed. 2002: 87F37-F41.
10. Whitelaw A. Intraventricular streptokinase after intraventricular hemorrhage. In: The Cochrane Library, Issue 1. Oxford: Update Software, 2000.
11. Hansen A, Whitelaw A, Lapp C, et al. Cerebrospinal fluid plasminogen activator inhibitor-1: a prognostic factor in posthaemorrhagic hydrocephalus. Acta Paediatr 1997; 86:995-8.
12. Whitelaw A, Mowinckel MC, Abildgaard U. Low levels of plasminogen in cerebrospinal fluid after intraventricular haemorrhage: a limiting factor for clot lysis? Acta Paediatr 1995; 84:933-6.
13. Pople IK, Ettles D. The role of endoscopic choroid plexus coagulation in the management of hydrocephalus. Neurosurgery 1995; 36:698-701.
14. Buxton N, Macarthur D, Malluci C, et al. Neuroendoscopy in the premature population. Childs Nerv Syst 1998; 14:649-52.
15. Schulte J, Osborne J, Benson JW, et al. Developmental outcome of the use of etamsylate for prevention of periventricular haemorrhage in a randomised controlled trial. Arch Dis Child Fetal Neonatal Ed. 2005; 90:F31-5.
16. McLendon D, Check J, Carteaux P, et al. Implementation of potentially better practices for the prevention of brain hemorrhage and ischemic brain injury in very low birth weight infants. Pediatrics 2003; 111:497-503.