Hydrocephalus Clinical Trial
Official title:
International Infant Hydrocephalus Study: A Multicentre, Prospective Study
The purpose of this study is to study whether infants with triventricular hydrocephalus (TVH) have a better long-term outcome at 5 years when they are treated with a new procedure, endoscopic third ventriculostomy (ETV), than infants treated with the more traditional treatment, insertion of a cerebrospinal fluid (CSF) shunt.
TVH is a relatively uncommon condition in infants, in which CSF accumulates in the brain's
ventricles due to a blockage in outflow at the level of cerebral aqueduct. This can cause
increased intracranial pressure, with adverse effect on brain development. The causes of this
include congenital aqueductal stensois or acquired aqueductal stenosis from previous brain
hemorrhage or infection.
TVH is currently treated through one of the following two approaches:
- Extra-cranial CSF diversion through ventricular shunts. Extra-cranial shunting has been
the standard approach over the past few decades, since functional shunts were first
developed and inserted successfully.
- Intra-cranial internal CSF diversion using endoscopic techniques. The principles of
internal diversion were clear from the time neurosurgeons first understood the nature of
hydrocephalus. However, internal diversion was never really practical or successful on a
large scale until the more recent development of neuroendoscopy. There is currently a
revived interest in diversionary hydrocephalus treatment through neuroendoscopic
surgical techniques, with the primary focus on endoscopic third ventriculostomy (ETV).
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