Abstract / Summary
Abstract Objective : Investigate associations between proactive vs. historical neonatal post-hemorrhagic hydrocephalus (PHH) surgical management and subsequent neurodevelopmental impairment (NDI). Study Design : Single-center retrospective, matched cohort of VLBW infants with PHH. Cases underwent earlier ventricular reservoir placement, serial imaging-guided cerebrospinal fluid withdrawal, reservoir weaning. Controls received historical management with later reservoir placement, symptom-driven cerebrospinal fluid withdrawal, earlier shunt conversion. Capute Cognitive Adaptive Test (CAT), Clinical Linguistic and Auditory Milestone Scale (CLAMS), Modified Peabody Developmental Motor Scale (PDMS-M)and Ages and Stages Questionnaires®, (ASQ) neurodevelopmental assessments during first two years compared between groups using Sign, McNemar-Bowker, Wilcoxon signed-rank and matched t-tests. Result : 48 subjects (24/group) included. NDI was common (67% Cases, 75% Controls). Composite NDI, individual NDI composite outcome components (CAT/CLAMS/PDMS-M), nor ASQ scores differed between groups. Conclusion : Proactive management was not associated with worse NDI, supporting its potential safety. Higher-powered studies with longer follow-up intervals are needed to assess potential developmental benefits.