Posthemorrhagic hydrocephalus in the preterm infant

Between 1969 and 1978 we treated 22 low birth weight infants for delayed onset posthemorrhagic hydrocephalus. All developed clinical signs of hydrocephalus after 2 weeks of age. The diagnosis was determined in 12 infants before August 1974, and they were treated by surgical placement of a shunt. In the ten infants born after September 1974, an attempt was first made to control the hydrocephalus with repeated lumbar puncture and diuretics prior to placing a shunt. In seven of the ten the hydrocephalus was successfully arrested by medical therapy alone. Follow-up assessments at 1 to 8 years of age were done on 18 infants. Two of the 12 treated by permanent shunts and three of six treated medically had an IQ score of 85 or greater. These results indicate a poor long-term outlook for the low birth weight infant who develops clinically overt hydrocephalus after intracranial bleeding.