Neonatal posthemorrhagic ventricular dilatation: Monitoring and medical intervention

Posthemorrhagic ventricular dilatation (PHVD) and posthemorrhagic hydrocephalus (PHH) remain major complications of intraventricular hemorrhage in extremely preterm infants. These conditions reflect multifactorial disturbances in cerebrospinal fluid dynamics, involving impaired resorption, obstruction of flow, and inflammation-mediated injury. Advances in neuroimaging and early intervention strategies have improved recognition and management; however, significant variability persists among centers regarding the timing and thresholds for treatment. This review summarizes current understanding of PHVD pathophysiology, brain maturation effects, and evidence-based monitoring and medical management, with particular emphasis on randomized controlled trials and meta-analyses. We emphasize the pivotal role of quantitative cranial ultrasonography and early, individualized intervention in mitigating progressive brain injury and optimizing neurodevelopmental outcomes.