Post-hemorrhagic hydrocephalus in preterm infants

In preterm infants, germinal matrix hemorrhage, intraventricular hemorrhage (IVH) and resultant post-hemorrhagic hydrocephalus (PHH) are common and important determinants of long-term cognitive outcomes. The management of IVH and PHH has undergone an evolution over the past decades, with current paradigms involving treatment with initial temporising measures followed by definitive management (if necessary) at around term-equivalent age. In this chapter, we discuss these current paradigms, examining the evidence for key decision points and the different temporising measures and conclude by presenting our institutional treatment algorithm. In addition, we look to the future, covering novel treatments such as neuroendoscopic lavage which may be crucial in improving the long-term neurodevelopmental outcomes in these patients.