1. Cranial and ventricular size following shunting or endoscopic third ventriculostomy (ETV) in infants with aqueductal stenosis: further insights from the International Infant Hydrocephalus Study (IIHS)
- Author
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Ian C, Coulter, Abhaya V, Kulkarni, Spyros, Sgouros, Shlomi, Constantini, Yael, Leitner, John Rw, Kestle, Douglas D, Cochrane, Maurice, Choux, Fleming, Gjerris, Adina, Sherer, Nejat, Akalan, Burçak, Bilginer, Ramon, Navarro, Ljiljana, Vujotic, Hannes, Haberl, Ulrich-Wilhelm, Thomale, Graciela, Zúccaro, Roberto, Jaimovitch, David, Frim, Lori, Loftis, Dale M, Swift, Brian, Robertson, Lynn, Gargan, László, Bognár, László, Novák, Georgina, Cseke, Armando, Cama, Giuseppe Marcello, Ravegnani, Matthias, Preuß, Henry W, Schroeder, Michael, Fritsch, Joerg, Baldauf, Marek, Mandera, Jerzy, Luszawski, Patrycja, Skorupka, Conor, Mallucci, Dawn, Williams, Krzysztof, Zakrzewski, Emilia, Nowoslawska, Chhitij, Srivastava, Ashok K, Mahapatra, Raj, Kumar, Rabi Narayan, Sahu, Armen G, Melikian, Anton, Korshunov, Anna, Galstyan, Ashish, Suri, Deepak, Gupta, J André, Grotenhuis, Erik J, van Lindert, José Aloysio, da Costa Val, Concezio, Di Rocco, Gianpiero, Tamburrini, Samuel Tau, Zymberg, Sergio, Cavalheiro, Ma, Jie, Jiang, Feng, Orna, Friedman, Naheeda, Rajmohamed, Marcin, Roszkowski, Slawomir, Barszcz, George, Jallo, David W, Pincus, Bridget, Richter, H M, Mehdorn, Susan, Schultka, Sandrine, de Ribaupierre, Dominic, Thompson, Silvia, Gatscher, Wolfgang, Wagner, Dorothee, Koch, Saverio, Cipri, Claudio, Zaccone, Patrick, McDonald, and Beyin ve Sinir Cerrahisi
- Subjects
medicine.medical_specialty ,Shunt ,Ventriculostomy ,03 medical and health sciences ,0302 clinical medicine ,Post-hoc analysis ,medicine ,Humans ,Prospective Studies ,030212 general & internal medicine ,Third Ventricle ,Infant hydrocephalus ,business.industry ,Endoscopic third ventriculostomy ,Infant ,General Medicine ,medicine.disease ,Surgery ,Hydrocephalus ,Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10] ,Shunting ,Treatment Outcome ,medicine.anatomical_structure ,Ventricle ,Aqueductal stenosis ,Neuroendoscopy ,Pediatrics, Perinatology and Child Health ,Cohort ,Neurology (clinical) ,Neurosurgery ,business ,International Infant Hydrocephalus Study ,030217 neurology & neurosurgery - Abstract
Purpose: The craniometrics of head circumference (HC) and ventricular size are part of the clinical assessment of infants with hydrocephalus and are often utilized in conjunction with other clinical and radiological parameters to determine the success of treatment. We aimed to assess the effect of endoscopic third ventriculostomy (ETV) and shunting on craniometric measurements during the follow-up of a cohort of infants with symptomatic triventricular hydrocephalus secondary to aqueductal stenosis. Methods: We performed a post hoc analysis of data from the International Infant Hydrocephalus Study (IIHS)-a prospective, multicenter study of infants (< 24 months old) with hydrocephalus from aqueductal stenosis who were treated with either an ETV or shunt. During various stages of a 5-year follow-up period, the following craniometrics were measured: HC, HC centile, HC z-score, and frontal-occipital horn ratio (FOR). Data were compared in an analysis of covariance, adjusting for baseline variables including age at surgery and sex. Results: Of 158 enrolled patients, 115 underwent an ETV, while 43 received a shunt. Both procedures led to improvements in the mean HC centile position and z-score, a trend which continued until the 5-year assessment point. A similar trend was noted for FOR which was measured at 12 months and 3 years following initial treatment. Although the values were consistently higher for ETV compared with shunt, the differences in HC value, centile, and z-score were not significant. ETV was associated with a significantly higher FOR compared with shunting at 12 months (0.52 vs 0.44; p = 0.002) and 3 years (0.46 vs 0.38; p = 0.03) of follow-up. Conclusion: ETV and shunting led to improvements in HC centile, z-score, and FOR measurements during long-term follow-up of infants with hydrocephalus secondary to aqueductal stenosis. Head size did not significantly differ between the treatment groups during follow-up, however ventricle size was greater in those undergoing ETV when measured at 1 and 3 years following treatment.
- Published
- 2020
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