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Open Access 01-11-2020 | Hydrocephalus | Original Article

ETV in infancy and childhood below 2 years of age for treatment of hydrocephalus

Authors: Ahmed El Damaty, Sascha Marx, Gesa Cohrs, Marcus Vollmer, Ahmed Eltanahy, Ehab El Refaee, Joerg Baldauf, Steffen Fleck, Heidi Baechli, Ahmed Zohdi, Michael Synowitz, Andreas Unterberg, Henry W. S. Schroeder

Published in: Child's Nervous System | Issue 11/2020

Abstract

Purpose

Age and etiology play a crucial role in success of endoscopic third ventriculostomy (ETV) as a treatment of obstructive hydrocephalus. Outcome is worse in infants, and controversies still exist whether ETV is superior to shunt placement. We retrospectively analyzed 70 patients below 2 years from 4 different centers treated with ETV and assessed success.

Methods

Children < 2 years who received an ETV within 1994–2018 were included. Patients were classified according to age and etiology; < 3, 4–12, and 13–24 months, etiologically; aqueductal stenosis, post-hemorrhagic-hydrocephalus (PHH), tumor-related, fourth ventricle outflow obstruction, with Chiari-type II and following CSF infection. We investigated statistically the predictors for ETV success through computing Kaplan-Meier estimates using patient’s follow-up time and time to ETV failure.

Results

We collected 70 patients. ETV success rate was 41.4%. The highest rate was in tumor-related hydrocephalus and fourth ventricle outlet obstruction (62.5%, 60%) and the lowest rate was in Chiari-type II and following infection (16.7%, 0%). The below 3 months age group showed relatively lower success rate (33.3%) in comparison to older groups which showed similar results (46.4%, 46.6%). Statistically, a previous VP shunt was a predictor for failure (p value < 0.05).

Conclusion

Factors suggesting a high possibility of failure were age < 3 months and etiology such as Chiari-type II or following infection. Altered CSF dynamics in patients with PHH and under-developed arachnoid villi may play a role in ETV failure. We do not recommend ETV as first line in children < 3 months of age or in case of Chiari II or following infection.

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Title: ETV in infancy and childhood below 2 years of age for treatment of hydrocephalus
Authors: Ahmed El Damaty
Sascha Marx
Gesa Cohrs
Marcus Vollmer
Ahmed Eltanahy
Ehab El Refaee
Joerg Baldauf
Steffen Fleck
Heidi Baechli
Ahmed Zohdi
Michael Synowitz
Andreas Unterberg
Henry W. S. Schroeder
Publication date: 01-11-2020
Publisher: Springer Berlin Heidelberg
Keywords: Hydrocephalus
Hydrocephalus
Hydrocephalus
Published in: Child's Nervous System / Issue 11/2020
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-020-04585-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

ETV in infancy and childhood below 2 years of age for treatment of hydrocephalus

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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