2019
DOI: 10.1002/jnr.24394
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Posthemorrhagic hydrocephalus development after germinal matrix hemorrhage: Established mechanisms and proposed pathways

Abstract: In addition to being the leading cause of morbidity and mortality in premature infants, germinal matrix hemorrhage (GMH) is also the leading cause of acquired infantile hydrocephalus. The pathophysiology of posthemorrhagic hydrocephalus (PHH) development after GMH is complex and vaguely understood, although evidence suggests fibrosis and gliosis in the periventricular and subarachnoid spaces disrupts normal cerebrospinal fluid (CSF) dynamics. Theories explaining general hydrocephalus etiology have substantiall… Show more

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Cited by 65 publications
(59 citation statements)
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References 148 publications
(194 reference statements)
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“…There is also a management trial (ELVIS TRIAL) comparing early versus late approach in lumbar tapping and rickham insertion, which is underway (de Vries et al, 2019). It is known that blood rapidly accumulates within the ventricles following IVH, and this leads to disruption of normal cerebrospinal fluid flux and can cause obstruction and increased local tissue pressure as one of the potential etiological mechanisms (Klebe et al, 2020). As described in Table 2, reports about preterm human data, brain cell death, and IVH are rare, and consist in analyses of tissue from autopsy and clinical data in preterm infants, about apoptotic and necrotic markers detected in the cerebrospinal fluid (Felderhoff-Mueser et al, 2003;Schmitz et al, 2011), in the ganglionic eminence (Del Bigio, 2011), and in the periventricular zone (Hargitai et al, 2001;Chamnanvanakij et al, 2002;Georgiadis et al, 2008).…”
Section: Intraventricular and Intraparenchymatous Hemorrhagesmentioning
confidence: 99%
See 1 more Smart Citation
“…There is also a management trial (ELVIS TRIAL) comparing early versus late approach in lumbar tapping and rickham insertion, which is underway (de Vries et al, 2019). It is known that blood rapidly accumulates within the ventricles following IVH, and this leads to disruption of normal cerebrospinal fluid flux and can cause obstruction and increased local tissue pressure as one of the potential etiological mechanisms (Klebe et al, 2020). As described in Table 2, reports about preterm human data, brain cell death, and IVH are rare, and consist in analyses of tissue from autopsy and clinical data in preterm infants, about apoptotic and necrotic markers detected in the cerebrospinal fluid (Felderhoff-Mueser et al, 2003;Schmitz et al, 2011), in the ganglionic eminence (Del Bigio, 2011), and in the periventricular zone (Hargitai et al, 2001;Chamnanvanakij et al, 2002;Georgiadis et al, 2008).…”
Section: Intraventricular and Intraparenchymatous Hemorrhagesmentioning
confidence: 99%
“…When leaving the hypoxic intrauterine milieu, the preterm infant will be exposed to either diminished or excessive oxygen saturation and variation in cerebral blood flow, which are potentially harmful for the retina, the lung, but also the brain and the neurodevelopmental outcome at long term [Safe Boosc (Askie et al, 2011;Panfoli et al, 2018)]. Therefore, targeting specific oxygen saturation, and regional cerebral oxygenation levels through different methods such as near-infrared spectroscopy (NIRS) are widespread in the neonatal intensive care units, and several trials are still ongoing to confirm the detrimental effect of hypo/hyperoxia and free radical stress in preterm brain injury (Klebe et al, 2020). These data are supported by a tremendous work of body on preclinical models, which are described later.…”
Section: Hyperoxiamentioning
confidence: 99%
“…Klebe et al [24] tried to reconcile our knowledge of germinal matrix hemorrhage (GMH) with or without intraventricular hemorrhage (IVH) and the consequent PHH development with the current hydrodynamic theory of hydrocephalus. PHH after GMH may be obstructive, non-communicating hydrocephalus during the acute phase due to the hematoma, but generally develops as chronic communicating hydrocephalus into adolescence and adulthood.…”
Section: Etv Success In Children Below 2 Years Of Agementioning
confidence: 99%
“…Nissl staining was conducted and analyzed as previously described [18]. Brain sections were dehydrated in 95% and 70% ethanol for 2 min and then washed in distilled water for 2 min.…”
Section: Nissl Stainingmentioning
confidence: 99%