Early entrapment of fourth ventricle following Pseudomonas meningitis in extreme prematurity: Case report

Edison, P.E.*, Sanamandra, S.K., Shah, V.A., Baral, V.R., Yeo, C.L. | JNPM 2020;


Trapped fourth ventricle (TFV) as a complication of post-hemorrhagic hydrocephalus (PHH) is widely reported in the pediatric population with a prior history of ventriculo-peritoneal (VP) shunt placement. Characterized by disproportionate dilatation of the fourth ventricle on serial neuro-imaging, it is rarely encountered in the early course of preterm infants and the differentiating clinical features are subtle and non-specific. Clinical alertness and sonographic correlation hold the key to early diagnosis. We report an early emergence of TFV in an extremely low gestational age newborn (ELGAN) following fulminant Pseudomonas aeruginosa meningitis, approach to management, and the neurological outcome. Fourth ventricle entrapment as a complication of perinatally acquired Pseudomonas aeruginosa meningitis in a surviving ELGAN is extremely rare.

*Corresponding Author: 

Priyantha Ebenezer Edison, MRCPCH (UK), Department of Neonatal and Developmental Medicine Singapore General Hospital, Singapore. Tel.: +65 63214540; Mobile: +65 9108 4996; Fax: +65 62273670; Postal Address: 20, College Road, Academia, Singapore 169856. E-mail: edison.priyantha.ebenezer@sgh.com.sg.