Abstract | OBJECT: METHODS: A total of 710 children underwent ventriculoscopy as candidates for ETV as the primary treatment for hydrocephalus. The ETV was accomplished in 550 children: 266 underwent a combined ETV- CPC procedure and 284 underwent ETV alone. The mean and median ages were 14 and 5 months, respectively, and 443 patients (81%) were younger than 1 year of age. The hydrocephalus was postinfectious (PIH) in 320 patients (58%), nonpostinfectious (NPIH) in 152 (28%), posthemorrhagic in five (1%), and associated with myelomeningocele in 73 (13%). The mean follow up was 19 months for ETV and 9.2 months for ETV- CPC. Overall, the success rate of ETV- CPC (66%) was superior to that of ETV alone (47%) among infants younger than 1 year of age (p < 0.0001). The ETV- CPC combined procedure was superior in patients with a myelomeningocele (76% compared with 35% success, p = 0.0045) and those with NPIH (70% compared with 38% success, p = 0.0025). Although the difference was not significant for PIH (62% compared with 52% success, p = 0.1607), a benefit was not ruled out (power = 0.3). For patients at least 1 year of age, there was no difference between the two procedures (80% success for each, p = 1.0000). The overall surgical mortality rate was 1.3%, and the infection rate was less than 1%. CONCLUSIONS: The ETV- CPC was more successful than ETV alone in infants younger than 1 year of age. In developing countries in which a dependence on shunts is dangerous, ETV- CPC may be the best option for treating hydrocephalus in infants, particularly for those with NPIH and myelomeningocele.
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Authors | Benjamin C Warf |
Journal | Journal of neurosurgery
(J Neurosurg)
Vol. 103
Issue 6 Suppl
Pg. 475-81
(Dec 2005)
ISSN: 0022-3085 [Print] United States |
PMID | 16383244
(Publication Type: Comparative Study, Controlled Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S.)
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Topics |
- Black People
- Brain Diseases
(complications)
- Cautery
(mortality)
- Cerebral Hemorrhage
(complications)
- Choroid Plexus
- Developing Countries
- Endoscopy
- Humans
- Hydrocephalus
(ethnology, etiology, surgery)
- Infant
- Infections
(complications)
- Meningomyelocele
(complications)
- Prospective Studies
- Treatment Outcome
- Uganda
- Ventriculostomy
(methods, mortality)
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