- Bottom line
- No difference in QOL at 5 years between ETV and shunts
- Design:
- Prospective, multicenter
- Based on either randomization or parental preference
- Assess
- QOL:
- Sample (n=158)
- ETV (n61)
- VPS (n78)
- Inclusion
- Infants (< 24 months old)
- Symptomatic triventricular hydrocephalus from aqueductal stenosis
- 1st treatment
- Born at > 36 weeks gestation
- Preoperative MRI showing aqueductal stenosis with no other major brain anomalies.
- History of intraventricular hemorrhage (intra-uterine or post-natal) or intracranial infection were included, unless this related to prematurity
- Exclusion
- Open spina bifida,
- Dandy-Walker syndrome with vermian agenesis/dysgenesis,
- Perinatal asphyxia,
- Severe brain dysmorphic anatomical features,
- Known chromosomal abnormality,
- Intracranial tumor
- Bottom line
- No difference between ETV+CPC and VPS with regard to cognitive outcomes, brain volume, treatment failure at 12 months
- Design:
- RCT 1 unit (Uganda)
- 1 outcome
- Bayley Scales of Infant Development, Third Edition (BSID-3), cognitive scaled score 12 months after surgery (scores range from 1 to 19, with higher scores indicating better performance).
- 2 outcome
- BSID-3 motor and language scores
- Treatment failure (defined as treatment-related death or the need for repeat surgery),
- Brain volume measured on CT
- Sample (n=100)
- ETV + CPC (n51)
- VPS (n49)
- Inclusion
- <180 days of age,
- Met established criteria for postinfectious hydrocephalus,
- A mother who was at least 18 years of age
- Lived in one of 31 districts in eastern Uganda that would facilitate access to follow-up
- Exclusion
- Active CSF infection,
- CT evidence of congenital brain anomaly,
- Severe anatomical brain distortion or multiloculated hydrocephalus due to infection, any of which would make ventricular endoscopy difficult.
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