External Ventricular Drain for the Management of Intraventricular Hemorrhage Secondary to Cerebral Venous Sinus Thrombosis in a Neonate: A Case-Based Review Publisher



Zafarshamspour S ; Kraemer AH ; Pahlevani M ; Lesha E ; Behzadi S ; Nejat F
Source: Journal of Pediatric Neurosciences Published:2025

Abstract

Purpose: This case report highlights the successful application of an external ventricular drain (EVD) in managing increased intracranial pressure (ICP) and intraventricular hemorrhage associated with neonatal cerebral venous sinus thrombosis (CVST), a rare but serious condition often overlooked due to its variable presentation. Materials and Methods: We describe the diagnosis and management of a 5-day-old term infant presenting with dehydration, hypernatremia, and intermittent seizures, who was subsequently diagnosed with CVST. We presented the clinical course, the use of an EVD for ICP management, and a review of the literature on diagnostic and therapeutic approaches for neonatal CVST. Results: Intravenous fluid resuscitation normalized the infant’s serum sodium, and anti-epileptic medication controlled the seizure 2. The EVD placement led to the resolution of intraventricular hemorrhage and ventriculomegaly with improved neurological status, allowing successful extubation. At 9-month follow-up, the child exhibited normal developmental milestones without hydrocephalus. Conclusion: In neonates presenting with hypernatremia and neurological deterioration, CVST should be promptly considered, and EVD may be considered an effective treatment option for managing increased ICP secondary to intraventricular hemorrhage. Further research and long-term follow-up are needed to better characterize the specific neurological impairments and developmental outcomes associated with neonatal CVST. © 2025 Journal of Pediatric Neurosciences.