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Current Trends in the Treatment of Pediatric Hydrocephalus: A Narrative Review Centered on the Indications, Safety, Efficacy, and Long-Term Outcomes of Available Treatment Modalities.
Children (Basel)
October 2024
Neurosurgical Department, General Hospital of Athens 'Gennimatas', 10676 Athens, Greece.
Article Synopsis
- The pathophysiology of pediatric hydrocephalus remains unclear, and valve-based shunt systems have been the primary treatment option since the 1950s, transitioning from ventricular-atrial systems to peritoneal systems in the 1970s.
- The review highlights the comparison of valve types and emphasizes endoscopic third ventriculostomy (ETV) as the only surgical alternative today, which offers lower infection and re-operation rates, especially for children with previous shunt failures.
- It also identifies key predictive factors for ETV success and attempts to determine optimal treatment strategies for different patient subgroups, aiming to improve long-term outcomes for pediatric hydrocephalus patients.
Ventriculoatrial shunt remains a safe surgical alternative for hydrocephalus: a systematic review and meta-analysis.
Sci Rep
August 2024
Neurosurgery Unit, Department of Neuroscience "Rita Levi Montalcini", AOU Città della Salute e della Scienza di Torino, University Hospital, University of Turin, 10124, Turin, Italy.
Article Synopsis
- Hydrocephalus is a medical condition that requires surgical solutions to manage excess cerebrospinal fluid, with the ventriculoperitoneal shunt (VPS) being the most common method used today.
- A systematic review and meta-analysis was conducted to compare the effectiveness and safety of VPS and ventriculoatrial shunt (VAS) techniques, analyzing data from nine studies involving 3,197 patients.
- The analysis found that the VAS had a significantly lower risk of shunt dysfunction, while risks of infection, revision, and death were statistically similar between the two methods but showed high variability across studies.
Experience of a reference center on ventriculo-gallbladder shunt as an alternative treatment for peritoneal failure in children.
Childs Nerv Syst
August 2024
Department of Pediatric Neurosurgery, National Institute of Health for Women, Children and Adolescent Fernandes Figueira/Fiocruz, Rio de Janeiro, Brazil.
Article Synopsis
- The study focuses on the ventriculo-gallbladder shunt (VGS) as an alternative to the standard ventriculo-peritoneal shunt for treating hydrocephalus in children who experience peritoneal failure.
- Conducted from January 2018 to December 2023, the research involved 18 patients with shunt dysfunction, with 10 undergoing successful VGS placement, showcasing a mean age of 35.4 months.
- Results indicated some temporary complications (like mild diarrhea and infections), but overall, the VGS showed promising outcomes with an average follow-up of 18.8 months without major issues.
Ventriculo-atrial shunt in idiopathic intracranial hypertension.
Acta Neurochir (Wien)
February 2024
Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, UK.
Purpose: CSF diversion is a recognised intervention in idiopathic intracranial hypertension (IIH), particularly in the presence of vision-threatening papilledema. Although ventriculo-atrial (VA) shunt insertion is a routine neurosurgical procedure, ventriculoperitoneal and lumboperitoneal shunts have been mostly used in this particular indication. This study aims to look at a single centre's experience with VA shunts in idiopathic intracranial hypertension (IIH).
View Article and Find Full Text PDFVentriculo-atrial shunt with occlusion of the internal jugular vein: operative experience and surgical technique.
Chin Neurosurg J
January 2024
Clinica Chicamocha, Bucaramanga, Santander, Colombia.
Background: Ventricular shunts are one of the most frequent techniques used for the management of hydrocephalus. The ventriculoperitoneal shunt (VPS) is the most commonly performed procedure, and the ventriculoatrial shunt (VAS) is the second option in most medical centers. The main objective of this study is to introduce and describe a surgical approach for VAS outlining our experience and comparing it with traditional shunting techniques.
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