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sbornikkonferenczii19iyunya2023

Materials and research methods: 
Evans Index, CT - computed tomography, 
MRI – magnetic imaging, NSG – neurosonography, CSF - cerebrospinal fluid, PCR 
- polymerase chain reaction, Apgar score, clinical and laboratory studies. The 
studies are based on an analysis of the results of treatment and examination of 90 
patients with secondary occlusal hydrocephalus, which developed against the 
background of IVH at the P "City Children's Hospital No. 2" in Nur-Sultan in the 
Department of Neurosurgery for the period 2009-2020. 
Results: 
The first group included 27 children with IVH grade 3-4, treated by 
external drainage and ventricular puncture + diuretics. Diuretics were used as 
symptomatic therapy, the basis of which was dehydration therapy - diacarb of 20-
30 mg / kg in combination with potassium preparations (aspartame). Of the 27 
children, 16 (56%) children survived (1A subgroup); 11 (44%) (1B subgroup) of 
them recorded a fatal outcome, which was caused by severe brain damage due to 
progressive hydrocephalus and concomitant multiple congenital malformations. 
The second group included 30 children, the treatment tactics of which consisted in 
the installation of ventriculosubgaleal drainage followed by ventriculoperitoneal 
shunting. Of the 31 children, 28 (93.3%) children (2A subgroup) survived, fatal 
outcome occurred in 2x (6.7%) children (2B subgroup). In 35 newborns with 
occlusion of the cerebrospinal fluid tract on the background of IVH grade 3-4. 
Ventriculosubgaleal drainage with intrathecal injection of thrombolytic agents into 
the subgaleal pocket was included in their treatment regimen. Of the 35 newborns, 
36 (97.1%) children (3A subgroup) survived, fatal outcome was observed in 1 
(2.8%) child (3B subgroup). 
Conclusions:
The developed combined technique for the treatment of 
occlusal hydrocephalus, which developed against the background of intraventricular 
hemorrhage, is reliable and more effective. 


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