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.