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This study aimed to compare morphometric remodeling on magnetic resonance imaging (MRI) after ETV between pediatric and adult patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective single-center study included 67 patients with TVH or LOVA (patent aqueduct), stratified into children with AqS (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200921), adults with AqS (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200924), adults with lesions (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200912), and adults with LOVA (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200910). Mamillopontine distance (MPD), Evans\u2019 index (EI), and third ventricle diameter (D3V) were measured preoperatively, postoperatively, and at follow-up. Longitudinal changes were compared within and between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Follow-up MRI was available in 88.1% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200959\/67). No child required shunt placement, compared with 12.5% of adults with AqS, 8.3% with lesions, and 30% with LOVA. Morphometric analysis revealed significant improvement (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) in MPD, EI, and D3V from baseline to follow-up in children and adults with AqS. Adults with lesions showed significant changes only in MPD and D3V, whereas adults with LOVA exhibited no significant differences. Between-group analyses confirmed the most distinct and consistent ventricular remodeling in pediatric patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Children demonstrated the most pronounced morphometric response after ETV, reflecting more effective ventricular remodeling than in adults. These findings suggest a stronger cerebrospinal fluid dynamic adaptation in pediatric patients, which may contribute to more favorable long-term outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00381-026-07166-3","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T09:22:45Z","timestamp":1771320165000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Morphometric changes after endoscopic third ventriculostomy: a pediatric\u2014adult comparison"],"prefix":"10.1007","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-9524-9150","authenticated-orcid":false,"given":"Dimitrios","family":"Emmanouilidis","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pawel","family":"Krukowski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6603-5375","authenticated-orcid":false,"given":"Witold","family":"Polanski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Pinzer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Zinke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3666-7128","authenticated-orcid":false,"given":"Sebastian","family":"Brenner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan B.","family":"Sobottka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8185-7764","authenticated-orcid":false,"given":"Ilker Y.","family":"Ey\u00fcpoglu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,2,17]]},"reference":[{"key":"7166_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3171\/foc.2005.19.6.11","volume":"19","author":"L Bognar","year":"2005","unstructured":"Bognar L, Markia B, Novak L (2005) Retrospective analysis of 400 neuroendoscopic interventions: the Hungarian experience. 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