We report the case of a preterm of 27 weeks of gestation who developed posthemorrhagic ventricular dilatation associated to a complete thrombosis of the superior sagittal sinus, for its peculiar interest in clarifying the physiology of the cerebrospinal fluid (CSF) dynamics.

The exact CSF volume that must be removed to improve cerebral hemodynamics and outcomes in infants with posthemorrhagic ventricular dilatation is unknown. According to Volpe's studies, a volume of 10 to 15 mL/kg/die of body weight is commonly chosen. The subject we report needed an excessive CSF drainage (up to 32 mL/kg/d), in presence of a functioning external ventricular drain.

We review the literature on the topic, and we postulate that the superior sagittal sinus may play an active role in the CSF dynamics of the immature brain (as it happens for the adult brain).

Written informed consent was obtained from the patient for publication of this case report and any accompanying images.

The manuscript was written in accordance with the Declaration of Helsinki.

Raw data supporting the conclusions of this manuscript can be made available by the authors to any qualified researcher without undue reservation.

L.A.R. conceptualize the study. C.A. and S.U. revised the subject's clinical history and the literature on the topic, interpreted the data, drew the pictures, and drafted the manuscript. C.A., S.U., M.B., M.P., and D.T. were involved in the clinical work on the illustrated subject. All authors discussed the results, commented on the manuscript, and approved the final version.

*Both the authors contributed equally.

Received: 17 August 2023

Accepted: 30 October 2023

Accepted Manuscript online:
01 November 2023

Article published online:
23 December 2023

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