TY - JOUR
T1 - Treatment of Posthemorrhagic Hydrocephalus in neonates (TROPHY) registry
T2 - surgical results from 6-month follow-up data
AU - Thomale, Ulrich-Wilhelm
AU - Bogoslovskaia, Elena
AU - Knerlich-Lukoschus, Friederike
AU - Akimov, Andrey
AU - Spennato, Pietro
AU - Auer, Christian
AU - El Damaty, Ahmed
AU - Schaumann, Andreas
AU - Pennacchietti, Valentina
AU - Schulz, Matthias
AU - Buis, Dennis
AU - Demyanenko, Vladislav
AU - Seliverstov, Alexander
AU - Usatova, Oksana
AU - Ozgural, Onur
AU - Kahilogullari, Gokmen
AU - Schuhmann, Martin U
AU - Jimenez-Guerra, Rolando
AU - Beez, Thomas
AU - Wittayanakorn, Nunthasiri
AU - Sukharev, Alexey
AU - Linsler, Stefan
AU - Oertel, Joachim
AU - Vacek, Petr
AU - Pankratiev, Ruslan
AU - Timershin, Ayrat
AU - Lovha, Mykhailo
AU - Guzman, Raphael
AU - Stricker, Sarah
AU - Wiegand, Christoph
AU - Votoupal, Megan
AU - Medoev, Soslan
AU - Fatykhova, Elza
AU - Kovalkov, Konstantin
AU - Pogosova, Dina
AU - Bührer, Christoph
AU - Lam, Sandi
AU - Sgouros, Spyros
AU - Roth, Jonathan
AU - Constantini, Shlomi
AU - Cavalheiro, Sergio
AU - Cinalli, Giuseppe
AU - Kulkarni, Abhaya V
AU - Gorelyshev, Sergey
AU - Bock, Hans Christoph
PY - 2025/12/5
Y1 - 2025/12/5
N2 - OBJECTIVE: Hydrocephalus due to intraventricular hemorrhage (IVH) during prematurity represents a challenging form of CSF circulation disturbance. It remains unresolved as to which temporary measures are best for intracranial pressure relief before sufficient body weight is reached to perform shunt implantation. The international Treatment of Posthemorrhagic Hydrocephalus in neonates (TROPHY) registry was designed to compare the safety and efficacy of 4 different methods of temporary treatment. The aim of this study was to investigate 6-month follow-up data from the TROPHY registry to characterize and compare perioperative measures, reoperations, complications, and shunt dependency among the different treatment methods.METHODS: An online registry designed for multicenter international prospective data collection was reviewed for patients with complete datasets that included 6-month follow-up data. Eligible patients were neonates with IVH and progressive ventricular enlargement necessitating surgical pressure relief. Four possible methods of intervention were assessed: ventricular access device (VAD) placement, external ventricular drainage (EVD), ventricular subgaleal shunt (VSGS) placement, and neuroendoscopic lavage (NEL). Preoperative data, perioperative aspects of surgery, and 6-month follow-up data were collected in a standardized manner.RESULTS: Of 238 patients with posthemorrhagic hydrocephalus (PHH) included in this analysis, 47 received a VAD, 34 received EVD, 75 received a VSGS, and 82 received NEL. After 6 months of follow-up, differences were seen in the rate of unilateral frontal tissue defect at the entry point (p < 0.001, highest in the NEL group and lowest in the VAD group), multiloculated hydrocephalus (p < 0.05, highest in the EVD group and lowest in the NEL group), parenchymal defect (p < 0.05, highest in the VAD and lowest in the EVD group), and the proportion of patients needing a permanent shunt (p < 0.001, highest in the VSGS group and lowest in the NEL group). No significant differences were seen in rates of complications or revisions among the groups.CONCLUSIONS: Analysis of 6-month follow-up TROPHY registry data provided further insights into treatment options for PHH after neonatal IVH. NEL had the lowest probability of needing a shunt at 6 months. Further research will be performed to draw clearer conclusions.
AB - OBJECTIVE: Hydrocephalus due to intraventricular hemorrhage (IVH) during prematurity represents a challenging form of CSF circulation disturbance. It remains unresolved as to which temporary measures are best for intracranial pressure relief before sufficient body weight is reached to perform shunt implantation. The international Treatment of Posthemorrhagic Hydrocephalus in neonates (TROPHY) registry was designed to compare the safety and efficacy of 4 different methods of temporary treatment. The aim of this study was to investigate 6-month follow-up data from the TROPHY registry to characterize and compare perioperative measures, reoperations, complications, and shunt dependency among the different treatment methods.METHODS: An online registry designed for multicenter international prospective data collection was reviewed for patients with complete datasets that included 6-month follow-up data. Eligible patients were neonates with IVH and progressive ventricular enlargement necessitating surgical pressure relief. Four possible methods of intervention were assessed: ventricular access device (VAD) placement, external ventricular drainage (EVD), ventricular subgaleal shunt (VSGS) placement, and neuroendoscopic lavage (NEL). Preoperative data, perioperative aspects of surgery, and 6-month follow-up data were collected in a standardized manner.RESULTS: Of 238 patients with posthemorrhagic hydrocephalus (PHH) included in this analysis, 47 received a VAD, 34 received EVD, 75 received a VSGS, and 82 received NEL. After 6 months of follow-up, differences were seen in the rate of unilateral frontal tissue defect at the entry point (p < 0.001, highest in the NEL group and lowest in the VAD group), multiloculated hydrocephalus (p < 0.05, highest in the EVD group and lowest in the NEL group), parenchymal defect (p < 0.05, highest in the VAD and lowest in the EVD group), and the proportion of patients needing a permanent shunt (p < 0.001, highest in the VSGS group and lowest in the NEL group). No significant differences were seen in rates of complications or revisions among the groups.CONCLUSIONS: Analysis of 6-month follow-up TROPHY registry data provided further insights into treatment options for PHH after neonatal IVH. NEL had the lowest probability of needing a shunt at 6 months. Further research will be performed to draw clearer conclusions.
UR - https://www.scopus.com/pages/publications/105027410951
U2 - 10.3171/2025.7.PEDS25167
DO - 10.3171/2025.7.PEDS25167
M3 - Article
C2 - 41349021
SN - 1933-0707
VL - 37
SP - 1
EP - 11
JO - Journal of neurosurgery. Pediatrics
JF - Journal of neurosurgery. Pediatrics
IS - 1
ER -