• Raffaele Falsaperla, Manuela Lo Bianco, Antonio Palmeri, Pasqua Betta, Roberto Altieri, Giuseppe Maria Barbagallo, and Martino Ruggieri.
• Neonatal Intensive Care Unit (NICU) and Neonatal Accompaniment Unit, Azienda Ospedaliero-Universitaria "Policlinico", PO "San Marco", University of Catania, Catania , Italy.
• Neurosurgery. 2023 Sep 1; 93 (3): 622627622-627.

BackgroundDifferent temporizing neurosurgical procedures are available for the management of posthemorrhagic hydrocephalus in preterm newborns.ObjectiveTo evaluate the short efficacy of the external ventricular drains (EVDs) and the ventriculosubgaleal (VSG) shunt.MethodsThis is a Strengthening the Reporting of Observational Studies in Epidemiology-conformed retrospective cohort study. The inclusion criteria were (1) gestational age <37 weeks, (2) birth weight <1500 g, (3) posthemorrhagic hydrocephalus because of intraventricular hemorrhage grade II/III, and (4) EVD or VSG shunt procedure before ventriculoperitoneal (VP)-definite shunt. Twenty-four newborns were collected from 2006 to 2022. The end points considered were infectious events, proteinorrachia, reintervention rate, and time to conversion to definite VP shunt.ResultsOverall, 12/24 newborns underwent EVD, and the remnant had a VSG shunt. The results showed a statistically significant difference ( P = .02) concerning cerebrospinal fluid infections between the EVD group (50%) and VSG shunt 1 (8.33%). The reintervention rate of EVD was significantly higher (66.67%) compared with that of the VSG shunt group (8.33%). A statistically significant difference was stated between the 2 groups (t[13] = -8.250; P < .001) (mean difference ± standard error; 10.5 ± 1.273) in the mean number of days elapsed from the achievement of the ideal weight (2000 g) to the definitive VP drainage.ConclusionThe increased infectious risk and the higher reintervention rate in EVD were confirmed in this study. In addition, a significant delay in the time to -conversion from EVD to VP shunt was demonstrated. Despite these optimal results, the VSG shunt remains a low practiced intervention, probably because of the limited operator experience.Copyright © Congress of Neurological Surgeons 2023. All rights reserved.

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