Hydrocephalus in infants less than six months of age: effectiveness of endoscopic third ventriculostomy
Although endoscopic third ventriculostomy (ETV) is a well established procedure for the treatment of congenital and acquired hydrocephalus, there is still a controversy with regard to the higher risk of failure in younger infants compared to older children after such a procedure. The aim of this art...
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Published in | European journal of pediatric surgery Vol. 19; no. 4; p. 216 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
United States
01.08.2009
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Subjects | |
Online Access | Get more information |
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Summary: | Although endoscopic third ventriculostomy (ETV) is a well established procedure for the treatment of congenital and acquired hydrocephalus, there is still a controversy with regard to the higher risk of failure in younger infants compared to older children after such a procedure. The aim of this article is to define the effectiveness of third ventriculostomy for hydrocephalus in infants less than 6 months of age better and to determine possible positive predictive factors.
In a series of 126 consecutive patients who underwent ETV between January 2000 and December 2002, 21 procedures were performed on infants ranging in age from 23 to 180 days, and without a previous history of shunting. The follow-up period was 49 to 82 months.
The overall success rate of ETV was 67% (14/21). All failures occurred in the early postoperative period (average 38 days, range 25-88 days). The success rate varied with the etiology of the patient's hydrocephalus. The best results were obtained in patients with acqueductal stenosis, Dandy-Walker malformation and myelomeningocele. The least favorable results (50% failure rate) occurred in infants treated for post-hemorrhagic and post-meningitic hydrocephalus.
This study does not demonstrate a correlation between the age of the infants and the ETV success rate. The specific etiology of hydrocephalus is the most relevant prognostic factor in infants under six months of age. |
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ISSN: | 1439-359X |
DOI: | 10.1055/s-0029-1202282 |