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Ratios of head circumference to ventricular size vary over time and predict eventual need for CSF diversion in intraventricular hemorrhage of prematurity.

Publication ,  Journal Article
Venkatraman, V; Harward, SC; Bhasin, S; Calderon, K; Atkins, SL; Liu, B; Lee, H-J; Chow, S-C; Fuchs, HE; Thompson, EM
Published in: Childs Nerv Syst
March 2024

PURPOSE: Intraventricular hemorrhage (IVH) of prematurity can lead to hydrocephalus, sometimes necessitating permanent cerebrospinal fluid (CSF) diversion. We sought to characterize the relationship between head circumference (HC) and ventricular size in IVH over time to evaluate the clinical utility of serial HC measurements as a metric in determining the need for CSF diversion. METHODS: We included preterm infants with IVH born between January 2000 and May 2020. Three measures of ventricular size were obtained: ventricular index (VI), Evan's ratio (ER), and frontal occipital head ratio (FOHR). The Pearson correlations (r) between the initial (at birth) paired measurements of HC and ventricular size were reported. Multivariable longitudinal regression models were fit to examine the HC:ventricle size ratio, adjusting for the age of the infant, IVH grade (I/II vs. III/IV), need for CSF diversion, and sex. RESULTS: A total of 639 patients with an average gestational age of 27.5 weeks were included. IVH grade I/II and grade III/IV patients had a positive correlation between initial HC and VI (r = 0.47, p < 0.001 and r = 0.48, p < 0.001, respectively). In our longitudinal models, patients with a low-grade IVH (I/II) had an HC:VI ratio 0.52 higher than those with a high-grade IVH (p-value < 0.001). Patients with low-grade IVH had an HC:ER ratio 12.94 higher than those with high-grade IVH (p-value < 0.001). Patients with low-grade IVH had a HC:FOHR ratio 12.91 higher than those with high-grade IVH (p-value < 0.001). Infants who did not require CSF diversion had an HC:VI ratio 0.47 higher than those who eventually did (p < 0.001). Infants without CSF diversion had an HC:ER ratio 16.53 higher than those who received CSF diversion (p < 0.001). Infants without CSF diversion had an HC:FOHR ratio 15.45 higher than those who received CSF diversion (95% CI (11.34, 19.56), p < 0.001). CONCLUSIONS: There is a significant difference in the ratio of HC:VI, HC:ER, and HC:FOHR size between patients with high-grade IVH and low-grade IVH. Likewise, there is a significant difference in HC:VI, HC:ER, and HC:FOHR between those who did and did not have CSF diversion. The routine assessments of both head circumference and ventricle size by ultrasound are important clinical tools in infants with IVH of prematurity.

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Published In

Childs Nerv Syst

DOI

EISSN

1433-0350

Publication Date

March 2024

Volume

40

Issue

3

Start / End Page

673 / 684

Location

Germany

Related Subject Headings

  • Retrospective Studies
  • Neurology & Neurosurgery
  • Infant, Premature, Diseases
  • Infant, Premature
  • Infant, Newborn
  • Infant
  • Hydrocephalus
  • Humans
  • Gestational Age
  • Cerebral Ventricles
 

Citation

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Venkatraman, V., Harward, S. C., Bhasin, S., Calderon, K., Atkins, S. L., Liu, B., … Thompson, E. M. (2024). Ratios of head circumference to ventricular size vary over time and predict eventual need for CSF diversion in intraventricular hemorrhage of prematurity. Childs Nerv Syst, 40(3), 673–684. https://doi.org/10.1007/s00381-023-06176-9
Venkatraman, Vishal, Stephen C. Harward, Srijan Bhasin, Kylie Calderon, Sage L. Atkins, Beiyu Liu, Hui-Jie Lee, Shein-Chung Chow, Herbert E. Fuchs, and Eric M. Thompson. “Ratios of head circumference to ventricular size vary over time and predict eventual need for CSF diversion in intraventricular hemorrhage of prematurity.Childs Nerv Syst 40, no. 3 (March 2024): 673–84. https://doi.org/10.1007/s00381-023-06176-9.
Venkatraman V, Harward SC, Bhasin S, Calderon K, Atkins SL, Liu B, et al. Ratios of head circumference to ventricular size vary over time and predict eventual need for CSF diversion in intraventricular hemorrhage of prematurity. Childs Nerv Syst. 2024 Mar;40(3):673–84.
Venkatraman, Vishal, et al. “Ratios of head circumference to ventricular size vary over time and predict eventual need for CSF diversion in intraventricular hemorrhage of prematurity.Childs Nerv Syst, vol. 40, no. 3, Mar. 2024, pp. 673–84. Pubmed, doi:10.1007/s00381-023-06176-9.
Venkatraman V, Harward SC, Bhasin S, Calderon K, Atkins SL, Liu B, Lee H-J, Chow S-C, Fuchs HE, Thompson EM. Ratios of head circumference to ventricular size vary over time and predict eventual need for CSF diversion in intraventricular hemorrhage of prematurity. Childs Nerv Syst. 2024 Mar;40(3):673–684.
Journal cover image

Published In

Childs Nerv Syst

DOI

EISSN

1433-0350

Publication Date

March 2024

Volume

40

Issue

3

Start / End Page

673 / 684

Location

Germany

Related Subject Headings

  • Retrospective Studies
  • Neurology & Neurosurgery
  • Infant, Premature, Diseases
  • Infant, Premature
  • Infant, Newborn
  • Infant
  • Hydrocephalus
  • Humans
  • Gestational Age
  • Cerebral Ventricles