Posthaemorrhagic hydrocephalus. Diagnosis, differential diagnosis, treatment, and long-term results.

The clinical features, investigations, and results of treatment are described in a series of 47 infants with posthaemorrhagic hydrocephalus. 7 were unfit for treatment; 3 had medical (isosorbide) treatment alone, 2 of whom made a good recovery; the remaining 37 were surgically treated. 32 (68%) survived for 18 months to 16 years, but 12 of them are severely affected mentally and/or physically. The results can be considered satisfactory in 19 (40%), though there are only 9 (19%) without detectable sequelae. The most serious adverse prognostic features on admission were acute illness with active bleeding or neurological signs such as spasticity, fits, visual defects, or subdural effusions, and such infants did not recover without severe sequelae. The degree of hydrocephalus was also of prognostic value. Since results could have been far better with better management, it is hoped that the publication of this series will lead to better care and prognosis.