Search Results

You are looking at 1 - 10 of 451 items for :

  • All content x
Clear All
Free access

Thomas J. Gianaris, Ryan Nazar, Emily Middlebrook, David D. Gonda, Andrew Jea, and Daniel H. Fulkerson

E ndoscopic third ventriculostomy (ETV) is an accepted alternative to CSF shunting for treatment of hydrocephalus. ETV has a high rate of success in selected patients. Kulkarni et al. 18 created the ETV Success Score (ETVSS; Table 1 ); this system provides a simple, reproducible method of estimating the chance of success of the procedure at 6 months. The ETVSS calculates a score based on 3 factors: patient age, cause of hydrocephalus, and the presence or absence of a previous shunt. The score approximates the odds that the ETV will effectively treat

Free access

Jonathan Pindrik, Jay Riva-Cambrin, Abhaya V. Kulkarni, Jessica S. Alvey, Ron W. Reeder, Ian F. Pollack, John C. Wellons III, Eric M. Jackson, Curtis J. Rozzelle, William E. Whitehead, David D. Limbrick Jr., Robert P. Naftel, Chevis Shannon, Patrick J. McDonald, Mandeep S. Tamber, Todd C. Hankinson, Jason S. Hauptman, Tamara D. Simon, Mark D. Krieger, Richard Holubkov, John R. W. Kestle, and for the Hydrocephalus Clinical Research Network

C linical controversy remains regarding the optimal treatment strategy for permanent CSF diversion in new-onset hydrocephalus. Prior studies evaluating shunt insertion, endoscopic third ventriculostomy (ETV), and/or ETV with choroid plexus cauterization (CPC) have focused on standard outcome measures. Perioperative mortality rates have remained low among patients undergoing ETV with CPC (0%–2%) or CSF shunt insertion (0%). 1–6 While both types of procedures are associated with low rates of neurological morbidity, neuroendoscopic approaches have exhibited lower

Open access

Ahmad K. Alhaj, Tariq Al-Saadi, Marie-Noëlle Hébert-Blouin, Kevin Petrecca, and Roy W. R. Dudley

Endoscopic third ventriculostomy (ETV) is an effective treatment for noncommunicating hydrocephalus. 1–3 As predicted by the ETV Success Score (ETVSS), its effectiveness depends on patient age, the pathology causing hydrocephalus, and whether the patient had a previous ventriculoperitoneal (VP) shunt. Success rates reach 90% in well-selected candidates. 4 ETV has also been found to be a valuable salvage option for VP shunt malfunction, with success rates of 60%–80%. 5–10 In VP shunt–dependent women, the physiological changes of pregnancy may impair shunt

Free access

Albert M. Isaacs, Yarema B. Bezchlibnyk, Heather Yong, Dilip Koshy, Geberth Urbaneja, Walter J. Hader, and Mark G. Hamilton

T he mainstay long-term treatment of hydrocephalus is cerebrospinal fluid (CSF) diversion either by the insertion of ventricular shunt or the creation of a ventriculocisternostomy. 20 Ventriculoperitoneal (VP) shunt insertion remains the most popular modality for treating hydrocephalus, 27 although up to 50% of VP shunts fail within the first 2 years after insertion. 3 Over the past 2 decades, a paradigm shift away from VP shunting and toward endoscopic third ventriculostomy (ETV) has occurred in the treatment of many forms of hydrocephalus. 14 , 15

Free access

Harishchandra Lalgudi Srinivasan, Mitchell T. Foster, Kirsten van Baarsen, Dawn Hennigan, Benedetta Pettorini, and Conor Mallucci

.” 25 Later, disease progression (tumor recurrence or metastasis) and complications of adjuvant therapy may contribute to delayed hydrocephalus. Various management strategies are used in children presenting with PFT-associated hydrocephalus; CSF diversion can be achieved with external ventricular drainage (EVD), ventriculoperitoneal (VP) shunting, or endoscopic third ventriculostomy (ETV). Alternatively, the surgeon can proceed directly to tumor resection to primarily reopen CSF pathways. 24 Whether to perform CSF diversion (and which diversion to perform) prior to

Free access

Matthew G. Stovell, Rasheed Zakaria, Jonathan R. Ellenbogen, Mathew J. Gallagher, Michael D. Jenkinson, Caroline Hayhurst, and Conor L. Mallucci

O ver the last few decades, endoscopic third ventriculostomy (ETV) has become a common treatment for pediatric hydrocephalus. This development is due to improved safety of the procedure enabled through advances in MRI and endoscopic technology. Endoscopic third ventriculostomy has a high rate of early failure, which is influenced largely by the indications used for the procedure and also by the technical abilities and experience of the surgeon. Many studies have reported short-term success (≤ 6 months) and intermediate-term success (≤ 3 years) of ETV

Free access

Sarah C. Jernigan, Jay G. Berry, Dionne A. Graham, and Liliana Goumnerova

failure. 17 , 19 Alternative and potentially more successful methods to divert CSF in infants with hydrocephalus are being explored. Endoscopic third ventriculostomy (ETV), the original hydrocephalus treatment modality from the early 20th century, has regained attention in recent years as an alternative to catheter-shunted CSF diversion. However, single-institutional studies report that ETV is also associated with high failure rates (range 70%–80%) within 1 year in high-risk patients, such as infants under 1 year of age. 10–13 , 18 Therefore, we compared the

Restricted access

Abhaya V. Kulkarni, James M. Drake, John R. W. Kestle, Conor L. Mallucci, Spyros Sgouros, and Shlomi Constantini

T he debate over ETV versus CSF shunting for the treatment of childhood hydrocephalus remains largely unresolved. 1 , 2 , 4 , 6 , 7 , 9 , 11 , 16 , 18 , 20 Recently, we used confounder-adjustment techniques (propensity score modeling) to compare the failure rate of ETV versus shunt placement. 13 We found that, once adjusted for confounders, ETV is associated with a higher initial failure rate, but, over time, the failure rate becomes lower than that associated with shunt placement. In a separate publication, we used logistic regression techniques to

Restricted access

Ángela Ros-Sanjuán, Sara Iglesias-Moroño, Bienvenido Ros-López, Francisca Rius-Díaz, Andrea Delgado-Babiano, and Miguel Ángel Arráez-Sánchez

parallel study in patients treated successfully with endoscopic third ventriculostomy (ETV). The aims of this study were to determine the quality of life (using the HOQ-Sv) of a cohort of children with hydrocephalus treated by ETV, and analyze the clinical and radiological features associated with a better or worse functional status. Methods Study Cohort We undertook this cross-sectional study between September 2018 and December 2019. The parents of 40 school-aged children (5–18 years old) treated with ETV at the Regional University Hospital in Málaga, Spain, completed

Full access

Sukwoo Hong, Daisuke Hirokawa, Kenichi Usami, and Hideki Ogiwara

E ndoscopic third ventriculostomy (ETV) is an effective treatment for hydrocephalus (HCP). The ETV Success Score (ETVSS) is a score used to predict the probability of ETV success at 6 months from the surgery. 10 The ETVSS predicts the short-term success, but there have been few reports in the literature about the long-term outcome of ETV, especially after longer than 5 years. Published studies that have evaluated the relationship between the ETVSS and educational outcome have also been scarce. We performed a retrospective analysis to further clarify the long