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In reference to “Posthemorrhagic ventricular dilatation in preterm infants: When best to intervene?” Dr. Munakomi supports early intervention after intraventricular bleed and reframes the pertinent question to be how to predict early neuronal damage in these patients. He suggests using diffusion tensor imaging (DTI) to assess for anisotropy in the periventricular tracks and near-infrared spectroscopy (NIRS). Authors de Vries and Leijser agree that while predicting neuronal damage would be advantageous, it is not currently possible. NIRS monitoring, they suggest, may be used in combination with other modalities to inform the timing of neurosurgical intervention. Serial DTIs would be technically challenging in most centers, whereas head ultrasounds are more practical and may provide more useful information.
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Author disclosures are available upon request (journal{at}neurology.org).
- © 2018 American Academy of Neurology
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