Neurodevelopmental outcomes of premature infants with post-hemorrhagic hydrocephalus is the subject of a new research study at the Monroe Carell Jr. Children’s Hospital at Vanderbilt.
Chevis Shannon, MBA, MPH, Dr.PH., director of the Pediatric Neurosurgery Clinical Research Initiative, has received a $100,000 grant from the Gerber Foundation to support the research.
Post-hemorrhagic hydrocephalus (PHH) is the accumulation of cerebrospinal fluid after a brain bleed. It is a major complication of preterm birth and is associated with a three- to fourfold increase in the risk of cognitive and motor disability.
“We want to improve the care of infants with PHH, but we need more than just clinical metrics to help with treatment decisions,” Shannon said. “As advances in newborn medicine continue to improve the survival of very preterm infants, they also increase the number of children who endure the long-term neurological disabilities and diminished quality of life associated with PHH.”
The three-year, multi-site study will evaluate neurocognition at 18-22 months and 36-42 months and will compare those outcomes with the various treatment modalities, including permanent shunts and temporary fluid diversion and reservoirs.
An arm of the study will also evaluate levels of neurodevelopmental protein mediators to find PHH-associated elevations. Cerebrospinal fluid samples from Vanderbilt patients will be sent to David Limbrick, M.D., Ph.D., assistant professor of Neurological Surgery at St. Louis Children’s Hospital, who is leading that analysis.
“This research stems from the need to identify predictors of outcomes and potential treatment options in hopes of impacting the cognitive function of premature infants both in the short and long run,” Shannon said.
This project is ancillary to two current studies in the Hydrocephalus Clinical Research Network, a multi-site research collaborative of pediatric neurosurgery centers, which Children’s Hospital joined last year.
“Shunting Outcomes in Post Hemorrhagic Hydrocephalus (SOPHH),” led by John “Jay” Wellons III, M.D., MSPH, chief of Pediatric Neurosurgery at Children’s Hospital, investigates the impact of various procedures in the treatment of hydrocephalus. “Cerebrospinal Fluid Markers of Post-Hemorrhagic Hydrocephalus (SOPHH Biomarkers),” led by Limbrick, studies CSF protein biomarkers to identify higher risk premature infants in an effort to facilitate earlier diagnosis of PHH.
