ArticlePediatric research2026
Factors associated with ventriculoperitoneal shunt conversion and intraparenchymal hemorrhage following ventriculosubgaleal shunt for post-hemorrhagic ventricular dilatation.
Article in Pediatric research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPost-hemorrhagic ventricular dilatation (PHVD) is often managed with temporizing measures like ventriculosubgaleal shunts (VSGS). We aimed to identify factors associated with (1) ventriculoperitoneal shunt (VPS) conversion and (2) intraparenchymal hemorrhage (IPH) following VSGS.
methodsRetrospective cohort study of infants born ≤34 gestational age (GA) with PHVD managed with VSGS between 2012-2024. Clinical and imaging characteristics were compared between infants with and without VPS conversion and between infants with and without post-VSGS IPH.
resultsForty-two infants received VSGS. Compared to neonates without VPS (n = 7), those who received a VPS (n = 35) had lower GA at birth (mean 27.5 weeks [SD3.0] vs. 30.1 weeks [2.0], p = 0.029) and larger ventricular size ipsilateral to the catheter immediately after intervention (median ventricular index [mm above p97] 1.3 mm vs. -1.7 mm, p = 0.048, and median anterior horn width 6.5 mm vs. 3.7 mm, p = 0.022). IPH occurred in 9/42 (21%) infants following VSGS and no risk factors were identified.
conclusionGreater GA and smaller post-VSGS ventricular size were associated with lower rates of VPS conversion. Post-VSGS IPH was common, but the absence of associated factors suggests a heterogenous pathophysiology. Future work should focus on refining temporizing strategies to reduce VPS dependence and characterize the spectrum and pathogenesis of post-VSGS IPH. IMPACT: Greater gestational age at birth and smaller post-VSGS shunt ventricular size were associated with a lower likelihood of ventriculoperitoneal shunt conversion Post-VSGS intraparenchymal hemorrhage was common and exhibited topographic and morphologic heterogeneity. No risk factors for post-VSGS intraparenchymal hemorrhage were identified. The findings underscore the need to refine temporizing strategies in post-hemorrhagic ventricular dilatation to reduce ventriculoperitoneal shunt dependency and complications.
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