{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T22:26:13Z","timestamp":1776896773734,"version":"3.51.2"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2021,8,17]],"date-time":"2021-08-17T00:00:00Z","timestamp":1629158400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,8,17]],"date-time":"2021-08-17T00:00:00Z","timestamp":1629158400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Childs Nerv Syst"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>To review the use of different valve types in infants with hydrocephalus, in doing so, determining whether an optimal valve choice exists for this patient cohort.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We conducted (1) a literature review for all studies describing valve types used (programmable vs. non-programmable, valve size, pressure) in infants (\u2264\u20092\u00a0years) with hydrocephalus, (2) a review of data from the pivotal BASICS trial for infant patients and (3) a separate, institutional cohort study from Alder Hey Children\u2019s Hospital NHS Foundation Trust. The primary outcome was any revision not due to infection.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The search identified 19 studies that were included in the review. Most did not identify a superior valve choice between programmable and non-programmable, small compared to ultra-small, and differential pressure compared to flow-regulating valves. Five studies investigated a single-valve type without a comparator group. The BASICS data identified 391 infants, with no statistically significant difference between gravitational and programmable subgroups. The institutional data from our tertiary referral centre did not reveal any significant difference in failure rate between valve subtypes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Our review highlights the challenges of valve selection in infant hydrocephalus, reiterating that the concept of an optimal valve choice in this group remains a controversial one. While the infant-hydrocephalic population is at high risk of valve failure, heterogeneity and a lack of direct comparison between valves in the literature limit our ability to draw meaningful conclusions. Data that does exist suggests at present that there is no difference in non-infective failure rate are increasing in number, with the British valve subtypes in infant hydrocephalus, supported by both the randomised trial and institutional data in this study.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00381-021-05326-1","type":"journal-article","created":{"date-parts":[[2021,8,17]],"date-time":"2021-08-17T11:03:08Z","timestamp":1629198188000},"page":"3485-3495","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Infant hydrocephalus: what valve first?"],"prefix":"10.1007","volume":"37","author":[{"given":"Benjamin J.","family":"Hall","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9153-3077","authenticated-orcid":false,"given":"Conor S.","family":"Gillespie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geraint J.","family":"Sunderland","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth J.","family":"Conroy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dawn","family":"Hennigan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael D.","family":"Jenkinson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benedetta","family":"Pettorini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Conor","family":"Mallucci","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,8,17]]},"reference":[{"key":"5326_CR1","doi-asserted-by":"publisher","unstructured":"Tully HM et al (2014) Infantile hydrocephalus: a review of epidemiology, classification, and causes. Eur J Med Genet. https:\/\/doi.org\/10.1016\/j.ejmg.2014.06.002","DOI":"10.1016\/j.ejmg.2014.06.002"},{"key":"5326_CR2","doi-asserted-by":"publisher","unstructured":"Patwardhan RV et al (2005) Implanted Ventricular shunts in the United States: the billion-dollar-a-year cost of hydrocephalus treatment.\u00a0Neurosurgery 56(1):139\u201344. https:\/\/doi.org\/10.1227\/01.neu.0000146206.40375.41","DOI":"10.1227\/01.neu.0000146206.40375.41"},{"key":"5326_CR3","doi-asserted-by":"publisher","unstructured":"Lim J et al (2018) The cost of hydrocephalus: a cost-effectiveness model for evaluating surgical techniques.\u00a0J Paediatr Neurosurg 23(1):109\u2013118. https:\/\/doi.org\/10.3171\/2018.6.PEDS17654","DOI":"10.3171\/2018.6.PEDS17654"},{"key":"5326_CR4","doi-asserted-by":"publisher","unstructured":"Merkler AE et al (2017) The rate of complications after ventriculoperitoneal shunt surgery. World Neurosurg. https:\/\/doi.org\/10.1016\/j.wneu.2016.10.136","DOI":"10.1016\/j.wneu.2016.10.136"},{"key":"5326_CR5","doi-asserted-by":"publisher","unstructured":"Mallucci CL et al (2019) Antibiotic or silver versus standard ventriculoperitoneal shunts (BASICS): a multicentre, single-blinded, randomised trial and economic evaluation.\u00a0The Lancet. https:\/\/doi.org\/10.1016\/S0140-6736(19)31603-4","DOI":"10.1016\/S0140-6736(19)31603-4"},{"key":"5326_CR6","unstructured":"Whitehead et al (2021) The CSF Shunt Entry Site Trial (10\/02\/2021). Clinicaltrials.gov. Available from: https:\/\/www.clinicaltrials.gov\/ct2\/show\/NCT02425761"},{"key":"5326_CR7","doi-asserted-by":"crossref","unstructured":"Kestle JR, Riva-Cambrin J (2019)\u00a0Prospective multicenter studies in pediatric hydrocephalus. 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