Treatment of Posthemorrhagic Hydrocephalus in neonates (TROPHY) registry: surgical results from 6-month follow-up data
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 i...
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| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
February 2026
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| In: |
Journal of neurosurgery. Pediatrics
Year: 2025, Volume: 37, Issue: 2, Pages: 122-132 |
| ISSN: | 1933-0715 |
| DOI: | 10.3171/2025.7.PEDS25167 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.3171/2025.7.PEDS25167 Verlag, kostenfrei, Volltext: https://thejns.org/pediatrics/view/journals/j-neurosurg-pediatr/37/2/article-p122.xml 
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| Author Notes: | Ulrich-Wilhelm Thomale, MD, Elena Bogoslovskaia, MD, Friederike Knerlich-Lukoschus, MD, Andrey Akimov, MD, Pietro Spennato, MD, Christian Auer, MD, Ahmed El Damaty, MD, Andreas Schaumann, MD, Valentina Pennacchietti, MD, Matthias Schulz, MD, Dennis Buis, MD, Vladislav Demyanenko, MD, Alexander Seliverstov, MD, Oksana Usatova, MD, Onur Ozgural, MD, Gokmen Kahilogullari, MD, Martin U. Schuhmann, MD, Rolando Jimenez-Guerra, MD, Thomas Beez, MD, Nunthasiri Wittayanakorn, MD, Alexey Sukharev, MD, Stefan Linsler, MD, Joachim Oertel, MD, Petr Vacek, MD, Ruslan Pankratiev, MD, Ayrat Timershin, MD, Mykhailo Lovha, MD, Raphael Guzman, MD, Sarah Stricker, MD, Christoph Wiegand, MD, Megan Votoupal, Soslan Medoev, MD, Elza Fatykhova, MD, Konstantin Kovalkov, MD, Dina Pogosova, MD, Christoph Bührer, MD, Sandi Lam, MD, Spyros Sgouros, MD, Jonathan Roth, MD, Shlomi Constantini, MD, Sergio Cavalheiro, MD, Giuseppe Cinalli, MD, Abhaya V. Kulkarni, MD, Sergey Gorelyshev, MD, and Hans Christoph Bock, MD |
| Summary: | 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. |
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| Item Description: | Veröffentlicht: 5. Dezember 2025 Gesehen am 16.04.2026 |
| Physical Description: | Online Resource |
| ISSN: | 1933-0715 |
| DOI: | 10.3171/2025.7.PEDS25167 |