Relation between TGF-beta 1 levels in cerebrospinal fluid and ETV outcome in premature newborns with posthemorrhagic hydrocephalus.
Childs Nerv Syst
; 26(3): 333-41, 2010 Mar.
Article
em En
| MEDLINE
| ID: mdl-19823849
ABSTRACT
OBJECT Therapy of posthaemorrhagic hydrocephalus (PHH) by using ventriculo-peritoneal drainage bears considerable rate of complications and remains a challenge in premature newborns. The role of endoscopic third ventriculostomy (ETV) in these patients is unclear, through obstruction is proven in some patients with PHH. Transforming growth factor beta 1 (TGF-beta1) release into the cerebrospinal fluid (CSF) in time of primary bleeding is suggested as one of the possible pathophysiologic reasons of PHH formation. Relation between TGF-beta1 levels and ETV success rate has not been reported yet. The aim of our study is to detect group of patients, according to the levels of TGF-beta1, who have magnetic resonance imaging (MRI)-proven obstruction hydrocephalus without participation of hyporesorption-so that we can expect success of ETV. METHODS:
We followed 29 premature newborns with PHH during 2005-2007, all of them treated by Ommaya reservoir implantation and repeated taps with TGF-beta1 levels examination. In case of persisting hydrocephalus, MRI was performed. In 16 patients with proven obstruction, ETV was performed. We were successful in six patients (37,5%). We evaluated pathophysiological type of hydrocephalus and ETV succes rate and their relation to TGF-beta1 CSF levels.RESULTS:
We have proven statistically relevant probability in diagnosis of hyporesorptive hydrocephalus based on TGF-beta1 level in CSF. Value exceeding 3,296 pg/ml means 81,3% probability of present hyporesorption. Success rate of ETV in patients with MRI-verified obstruction and TGF-beta1 level lower than 3,296 pg/ml was 100% in our series.CONCLUSION:
TGF-beta1 level indicates participation of hyporesorption in hydrocephalus development and its level may influence decision making in ETV for premature newborns with PHH.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Recém-Nascido Prematuro
/
Hemorragias Intracranianas
/
Fator de Crescimento Transformador beta1
/
Hidrocefalia
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
/
Newborn
Idioma:
En
Revista:
Childs Nerv Syst
Assunto da revista:
NEUROLOGIA
/
PEDIATRIA
Ano de publicação:
2010
Tipo de documento:
Article
País de afiliação:
República Tcheca