Sequential therapy with lateral ventricular continuous external drainage combined with contralateral Ommaya reservoir for severe neonatal intraventricular hemorrhage and posthemorrhagic hydrocephalus: a retrospective controlled study.
Zhang X, Cheng Q, Qiu W, Liu F • Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery • 2026
Sequential therapy with lateral ventricular continuous external drainage combined with contralateral Ommaya reservoir implantation is safe and effective for neonates with severe IVH complicated by PHH, shortening external drainage duration and CSF recovery time with a trend toward fewer complications and less need for permanent shunt surgery compared with external drainage alone.
Key Findings
Results
External drainage duration was significantly shorter in neonates receiving external drainage plus contralateral Ommaya reservoir than in those receiving external drainage alone.
Observation group 3.8 ± 1.2 days vs. control group 5.5 ± 1.5 days (t = 3.55, P = 0.001).
Retrospective historically controlled study of 36 neonates with grade III-IV IVH and progressive hydrocephalus at Jiangxi Children's Hospital.
Control group (n = 10) was treated January 2016-December 2018; observation group (n = 26) January 2019-December 2024.
Results
Cerebrospinal fluid parameters normalized significantly faster in the observation group.
Times to normalization of CSF white blood cell count, protein, and glucose were all shorter in the observation group.
Reported t values were 5.30, 7.42, and 6.47, respectively; all P < 0.001.
Results
Ventricular size reduction on imaging was more frequent in the observation group than the control group.
Cranial imaging at 10-30 days postoperatively showed ventricular reduction in 92.3% (24/26) of the observation group.
Ventricular reduction was seen in 70.0% (7/10) of the control group.
The abstract does not report a significance test for this comparison.
Results
No patient in the observation group needed a permanent ventriculoperitoneal shunt, versus one control patient, a difference that was not statistically significant.
Follow-up was 12-18 months.
0/26 in the observation group vs. 1/10 (10.0%) in the control group required permanent VPS.
Fisher's exact P = 0.28.
Results
The overall complication rate was numerically lower in the observation group, but not significantly so.
Complication rate 3.8% (1/26) in the observation group vs. 20.0% (2/10) in the control group.
Fisher's exact P = 0.15.
Conclusions
The authors conclude the dual-channel sequential strategy is safe and effective and suggest clinical advantages over external drainage alone.
Advantages cited: shorter external drainage and faster CSF recovery, with trends toward fewer complications and less need for permanent shunt surgery.
The conclusion rests on a small, single-center, historically controlled retrospective design (n = 36).
What This Means
This study looked at newborns with severe bleeding in the brain's fluid spaces (grade III-IV intraventricular hemorrhage) who then developed a buildup of fluid (hydrocephalus). Doctors at one children's hospital in China compared two approaches. Ten babies treated earlier (2016-2018) had a tube draining fluid from one side of the brain. Twenty-six babies treated later (2019-2024) had the same drain plus a small implanted reservoir (an Ommaya reservoir) on the opposite side.
Babies who received the combined approach needed the external drain for a shorter time (about 3.8 days vs. 5.5 days), and their spinal fluid returned to normal (white cells, protein, glucose) faster. Brain scans showed the fluid spaces shrank in 92% of the combined-therapy group vs. 70% of the drain-only group. None of the 26 combined-therapy babies needed a permanent shunt over 12-18 months, compared with 1 of 10 in the drain-only group. Complications occurred in 1 of 26 vs. 2 of 10 babies. The shunt and complication differences were small and could have arisen by chance.</br></br>This research suggests the combined approach may be a safe option with some advantages over drainage alone. However, the study was small, done at one hospital, and compared babies treated in different time periods, so other changes in care over time could explain some differences. Larger studies that compare the approaches more directly would be needed to confirm the findings.
Zhang X, Cheng Q, Qiu W, Liu F. (2026). Sequential therapy with lateral ventricular continuous external drainage combined with contralateral Ommaya reservoir for severe neonatal intraventricular hemorrhage and posthemorrhagic hydrocephalus: a retrospective controlled study.. Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery. https://doi.org/10.1007/s00381-026-07514-3