Longitudinal comparison of diffusion tensor imaging parameters and neuropsychological measures following endoscopic third ventriculostomy for hydrocephalus

Case report

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  • 1 Departments of Neurological Surgery,
  • 2 Pediatrics,
  • 3 Psychology, and
  • 4 Radiology, St. Louis Children's Hospital, Washington University School of Medicine in St. Louis, Missouri;
  • 5 Departments of Neurological Surgery,
  • 6 Pediatrics, and
  • 7 Radiology; and
  • 8 Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital, Cincinnati, Ohio
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The authors report the case of a 25-month-old boy who underwent endoscopic third ventriculostomy (ETV) for hydrocephalus resulting from aqueductal stenosis. The patient's recovery was monitored longitudinally and prospectively using MR diffusion tensor imaging (DTI) and formal neuropsychological testing. Despite minimal change in ventricle size, improvement in the DTI characteristics and neurodevelopmental trajectory was observed following ETV. These data support the use of DTI as a biomarker to assess therapeutic response in children undergoing surgical treatment for hydrocephalus. In the patient featured in this report, DTI appeared to provide more information regarding postoperative neurodevelopmental outcome than ventricle size alone.

Abbreviations used in this paper:ABAS-II = Adaptive Behavior Assessment System, Second Edition; ALIC = anterior limb of the internal capsule; Bayley-III = Bayley Scales of Infant and Toddler Development, Third Edition; CBCL = Child Behavior Checklist; DTI = diffusion tensor imaging; ETV = endoscopic third ventriculostomy; FA = fractional anisotropy; gCC = genu of the corpus callosum; MD = mean diffusivity; OFC = occipitofrontal circumference; PLIC = posterior limb of the internal capsule; ROI = region of interest; sCC = splenium of the corpus callosum; WPPSI-III = Wechsler Preschool and Primary Scale of Intelligence, Third Edition.

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Contributor Notes

Address correspondence to: Robert T. Buckley, B.S., Washington University School of Medicine in St. Louis, One Children's Place, Suite 4S20, St. Louis, Missouri 63110. email: buckleyr@wusm.wustl.edu.

Please include this information when citing this paper: DOI: 10.3171/2012.2.PEDS11331.

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