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Endoscopic versus Shunt Treatment of Hydrocephalus in Infants

  • Status
    Accepting Candidates
  • Age
    N/A
  • Sexes
    All
  • Healthy Volunteers
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Description

Hydrocephalus largely affects babies under a year old. It has traditionally been treated by shunt insertion. A newer endoscopic procedure offers hope of a treatment that may reduce complications in a child's life, but it is unclear if the procedure results in similar intellectual outcome as shunt. We propose a randomized trial to compare intellectual outcome and brain structural integrity between these 2 treatments, to help families make the best treatment decision for their baby.

Details

Protocol number CED000000292

Eligibility

Inclusion Criteria (ALL of the following must be present): 听

  1. Corrected age听0. 45, which Approximates \moderate ventriculomegaly"2), and at least one of the following: -听Head circumference听>98th percentile for corrected age with bulging fontanelle or splayed sutures -听Upgaze paresis/palsy (sundowning) -听CSF leak 听Papilledema -听Tense pseudomeningocele or tense uid along a track -听Vomiting or irritability, with no other attributable cause -听Bradycardias or apneas, with no other attributable cause -听Intracranial pressure (ICP) monitoring showing persistent elevation of pressure with or without plateau waves AND 听 听 听
  2. No prior history of shunt insertion or endoscopic third ventriculostomy (ETV) procedure (previous temporization devices and/or external ventricular drains permissible) 听 听

Exclusion Criteria:

听

  1. Hydrocephalus due to intraventricular hemorrhage in a child born before 37 weeks gestational age; OR
  2. Anatomy not suitable for ETV+CPC or anteriorly placed ventriculoperitoneal shunt defined as: 听Moderate to severe prepontine adhesions on sagittal constructive interference steady state (CISS) fast imaging employing steady state acquisition (FIESTA) MRI 听Closure of one or both foramina of Monro 听Thick floor of third ventricle (听3mm) _听Narrow third ventricle ( 听

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