{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T02:38:19Z","timestamp":1792809499015,"version":"4.5.0"},"reference-count":34,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Children with nonoperative brain tumors, such as diffuse intrinsic pontine gliomas (DIPGs), often have life-threatening hydrocephalus. Palliative shunting is common in such cases but can be complicated by hardware infection and mechanical failure. Endoscopic third ventriculostomy (ETV) is a minimally invasive alternative to treat hydrocephalus without implanted hardware. Herein, the authors report their institutional experience with palliative ETV for primary pediatric brain tumors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The authors conducted a retrospective review of consecutive patients who had undergone palliative ETV for hydrocephalus secondary to nonresectable primary brain tumors over a 10-year period at Rady Children\u2019s Hospital. Collected variables included age, sex, tumor type, tumor location, presence of leptomeningeal spread, use of a robot for ETV, complications, ETV Success Score (ETVSS), functional status, length of survival, and follow-up time. A successful outcome was defined as an ETV performed without clinically significant perioperative complications or secondary requirement for a new shunt.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Fifteen patients met the study inclusion criteria (11 males, 4 females; average age 7.9 years, range 0.8\u201321 years). Thirteen patients underwent manual ETV, and 2 patients underwent robotic ETV. Preoperative symptoms included gaze palsy, nausea\/vomiting, headache, lethargy, hemiparesis, and seizures. Tumor types included DIPG (3), intraventricular\/thalamic glioblastoma (2), and leptomeningeal spread of medulloblastoma (2), anaplastic oligo-\/astrocytoma (2), rhabdoid tumor (2), primitive neuroectodermal tumor (1), ganglioglioma (1), pineoblastoma (1), and embryonal carcinoma (1). The mean preoperative ETVSS was 79 \u00b1 8.8. There was 1 perioperative complication, a wound breakdown consistent with refractory hydrocephalus. The mean follow-up was 4.9 \u00b1 5.5 months overall, and mean survival for the patients who died was 3.2 \u00b1 3.6 months. Two patients remained alive at a mean follow-up of 15.7 months. Palliative ETV was successful in 7 patients (47%) and unsuccessful in 8 (53%). While patients with successful ETV were significantly older (11.9 \u00b1 5.6 vs 4.4 \u00b1 4.1 years, p = 0.010), there were no significant differences in preoperative ETVSS (p = 0.796) or postoperative survival (p = 0.476) between the successful and unsuccessful groups. Overall, functional outcomes were similar between the two groups; there was no significant difference in posttreatment Karnofsky Performance Status scores (68.6 \u00b1 19.5 vs 61.3 \u00b1 16.3, p = 0.454), suggesting that including ETV in the treatment algorithm did not worsen outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Palliative ETV is a safe and potentially efficacious treatment option in selected pediatric patients with hydrocephalus from nonoperative brain tumors. Close follow-up, especially in younger children, is required to ensure that patients with refractory symptoms receive appropriate secondary CSF diversion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2021.3.peds20952","type":"journal-article","created":{"date-parts":[[2021,8,6]],"date-time":"2021-08-06T03:11:43Z","timestamp":1628219503000},"page":"387-394","source":"Crossref","is-referenced-by-count":5,"title":["Palliative endoscopic third ventriculostomy for pediatric primary brain tumors: a single-institution case series"],"prefix":"10.3171","volume":"28","author":[{"given":"Robert C.","family":"Rennert","sequence":"first","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael G.","family":"Brandel","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanmukha","family":"Srinivas","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Divya","family":"Prajapati","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar M.","family":"Al Jammal","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nolan J.","family":"Brown","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis D","family":"Diaz-Aguilar","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Elster","sequence":"additional","affiliation":[{"name":"Pediatrics, University of California San Diego, La Jolla; and"},{"name":"Rady Children\u2019s Hospital, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David D.","family":"Gonda","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"},{"name":"Neurosciences, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John R.","family":"Crawford","sequence":"additional","affiliation":[{"name":"Neurosciences, and"},{"name":"Pediatrics, University of California San Diego, La Jolla; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael L.","family":"Levy","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"},{"name":"Neurosciences, and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"12","key":"b1","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"1543","DOI":"10.1007\/s00381-006-0193-5","article-title":"The occurrence of obstructive vs absorptive hydrocephalus in newborns and infants: relevance to treatment choices","volume":"22","author":"Beni-Adani L","year":"2006","unstructured":"Beni-Adani L, Biani N, Ben-Sirah L, Constantini S. 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