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).

Autor: Coulter IC; The Hospital for Sick Children, University of Toronto, 555 University Avenue, Suite 1503, Toronto, Ontario, M5G 1X8, Canada., Kulkarni AV; The Hospital for Sick Children, University of Toronto, 555 University Avenue, Suite 1503, Toronto, Ontario, M5G 1X8, Canada. abhaya.kulkarni@sickkids.ca., Sgouros S; Department of Pediatric Neurosurgery, Mitera Children's Hospital, Athens, Greece.; University of Athens Medical School, Athens, Greece., Constantini S; Department of Pediatric Neurosurgery, Dana Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel., Constantini S, Sgouros S, Kulkarni AV, Leitner Y, Kestle JR, Cochrane DD, Choux M, Gjerris F, Sherer A, Akalan N, Bilginer B, Navarro R, Vujotic L, Haberl H, Thomale UW, Zúccaro G, Jaimovitch R, Frim D, Loftis L, Swift DM, Robertson B, Gargan L, Bognár L, Novák L, Cseke G, Cama A, Ravegnani GM, Preuß M, Schroeder HW, Fritsch M, Baldauf J, Mandera M, Luszawski J, Skorupka P, Mallucci C, Williams D, Zakrzewski K, Nowoslawska E, Srivastava C, Mahapatra AK, Kumar R, Sahu RN, Melikian AG, Korshunov A, Galstyan A, Suri A, Gupta D, Grotenhuis JA, van Lindert EJ, da Costa Val JA, Di Rocco C, Tamburrini G, Zymberg ST, Cavalheiro S, Jie M, Feng J, Friedman O, Rajmohamed N, Roszkowski M, Barszcz S, Jallo G, Pincus DW, Richter B, Mehdorn HM, Schultka S, de Ribaupierre S, Thompson D, Gatscher S, Wagner W, Koch D, Cipri S, Zaccone C, McDonald P
Jazyk: angličtina
Zdroj: Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery [Childs Nerv Syst] 2020 Jul; Vol. 36 (7), pp. 1407-1414. Date of Electronic Publication: 2020 Jan 21.
DOI: 10.1007/s00381-020-04503-y
Abstrakt: 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.
Databáze: MEDLINE
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