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. 2021 Sep 1;56(5):499–512. doi: 10.5152/TurkArchPediatr.2021.21142

Table 3.

Summary of Interventional Approaches (B1)

Low-threshold Interventional Approach High-threshold Interventional Approach
Scanning: After the onset of PHVD, cUS scanning at least twice a week should be initiated. Scanning: After the onset of PHVD, cUS scanning at least twice a week should be initiated.
Family Meeting: When the bilateral ventricular indices exceed the 97th percentile and anterior horn width exceeds 6mm and/or thalamo-occipital distance >25mm, a family meeting should be held and treatment plan should be clarified. Family Meeting: When the bilateral ventricular indices are 97th percentile + 4 mm line and anterior horn width >10mm and/or thalamo-occipital distance >25mm, a family meeting should be held and treatment plan should be clarified.
The First Lumbar Puncture: If progression in the ventricular measurements (progression from the yellow curve to the red curve in Figure 2) is observed, the first LP is performed (10 mL/kg). The First Lumbar Puncture: If this approach is adapted in the family meeting, the first LP is performed on the same day. LP volume is 10 mL/kg.
Subsequent Lumbar Punctures : If progression in the ventricular measurements continue 24-48 hours after the 1st LP, the 2nd LP is performed, and if the progression continues after 24-48 hours, the 3rd LP is performed. Subsequent Lumbar Punctures: If there is a progression in the ventricular measurements 24-48 hours after the 1st LP, the 2nd LP is performed, if the progression continues after 24-48 hours, the 3rd LP is performed.
Target: Bilateral ventricular indices being <97th percentile and the anterior horn width <6mm and thalamo-occipital distance <25 mm. Target: Bilateral ventricular indices being <97th percentile and the anterior horn width below 6mm and thalamo-occipital distance below 25 mm.
Maximum Number of Lumbar Punctures: 3 times. Maximum Number of Lumbar Punctures: 3 times.
Subsequent Interventions: If the ventricles continue to enlarge after a total of 3 LPs, reservoir or ventriculo-subgaleal shunt or external ventricular drainage is performed, in discussion with the neurosurgery team. Subsequent Interventions: If the ventricles continue to enlarge after a total of 3 LPs, reservoir or ventriculo-subgaleal shunt or external ventricular drainage is performed, in discussion with the neurosurgery team.