{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,14]],"date-time":"2026-11-14T02:31:22Z","timestamp":1794623482333,"version":"4.9.1"},"reference-count":25,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Postoperative routine imaging is common after pediatric ventricular shunt revision, but the benefit of scanning in the absence of symptoms is questionable. In this study, the authors aimed to assess how often routine scanning results in a change in clinical management after shunt revision.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The records of a large, tertiary pediatric hospital were retrospectively reviewed for all consecutive cases of pediatric shunt revision between July 2013 and July 2018. Postoperative imaging was classified as routine (i.e., in the absence of symptoms, complications, or other direct indications) or nonroutine. Reinterventions within 30 days were assessed in these groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Of 387 included shunt revisions performed in 232 patients, postoperative imaging was performed in 297 (77%), which was routine in 244 (63%) and nonroutine in 53 (14%). Ninety revisions (23%) underwent any shunt-related procedure after postoperative imaging, including shunt reprogramming (n = 35, 9%), shunt tap (n = 10, 3%), and a return to the operating room (OR; n = 58, 15%). Of the 244 cases receiving routine imaging, 241 did not undergo a change in clinical management solely based on routine imaging findings. The remaining 3 cases returned to the OR, accounting for 0.8% (95% CI 0.0%\u20131.7%) of all cases or 1.2% (95% CI 0.0%\u20132.6%) of cases that received routine imaging. Furthermore, 27 of 244 patients in this group returned to the OR for other reasons, namely complications (n = 12) or recurrent symptoms (n = 15); all arose after initial routine imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>The authors found a low yield to routine imaging after pediatric shunt revision, with only 0.8% of cases undergoing a change in management based on routine imaging findings without corresponding clinical findings. Moreover, routine imaging without abnormal findings was no guarantee of an uneventful postoperative course. Clinical monitoring can be considered as an alternative in asymptomatic, uncomplicated patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2021.9.peds21261","type":"journal-article","created":{"date-parts":[[2021,11,19]],"date-time":"2021-11-19T02:14:48Z","timestamp":1637288088000},"page":"276-282","source":"Crossref","is-referenced-by-count":7,"title":["The low utility of routine cranial imaging after pediatric shunt revision"],"prefix":"10.3171","volume":"29","author":[{"given":"Alexander F. C.","family":"Hulsbergen","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Boston Children\u2019s Hospital, Harvard Medical School, Boston, Massachusetts;"},{"name":"Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Siddi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Boston Children\u2019s Hospital, Harvard Medical School, Boston, Massachusetts;"},{"name":"Computational Neuroscience Outcomes Center (CNOC), Department of Neurosurgery, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, Massachusetts;"},{"name":"Department of Neurological Surgery, University of Padua, Padua, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malia","family":"McAvoy","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Boston Children\u2019s Hospital, Harvard Medical School, Boston, Massachusetts;"},{"name":"Computational Neuroscience Outcomes Center (CNOC), Department of Neurosurgery, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, Massachusetts;"},{"name":"Harvard-MIT Health Sciences and Technology, Harvard Medical School, Massachusetts Institute of Technology, Cambridge, Massachusetts; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin T.","family":"Lynch","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Boston Children\u2019s Hospital, Harvard Medical School, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madeline B.","family":"Karsten","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Boston Children\u2019s Hospital, Harvard Medical School, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brittany M.","family":"Stopa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Boston Children\u2019s Hospital, Harvard Medical School, Boston, Massachusetts;"},{"name":"Computational Neuroscience Outcomes Center (CNOC), Department of Neurosurgery, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Ashby","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Boston Children\u2019s Hospital, Harvard Medical School, Boston, Massachusetts;"},{"name":"Computational Neuroscience Outcomes Center (CNOC), Department of Neurosurgery, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"McNulty","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Boston Children\u2019s Hospital, Harvard Medical School, Boston, Massachusetts;"},{"name":"Computational Neuroscience Outcomes Center (CNOC), Department of Neurosurgery, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, Massachusetts;"},{"name":"Columbia University Vagelos College of Physicians and Surgeons, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marike L. D.","family":"Broekman","sequence":"additional","affiliation":[{"name":"Computational Neuroscience Outcomes Center (CNOC), Department of Neurosurgery, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, Massachusetts;"},{"name":"Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William B.","family":"Gormley","sequence":"additional","affiliation":[{"name":"Computational Neuroscience Outcomes Center (CNOC), Department of Neurosurgery, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scellig S. D.","family":"Stone","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Boston Children\u2019s Hospital, Harvard Medical School, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin C.","family":"Warf","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Boston Children\u2019s Hospital, Harvard Medical School, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark R.","family":"Proctor","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Boston Children\u2019s Hospital, Harvard Medical School, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"10","key":"b1","series-title":"PLoS One","first-page":"e0204926","article-title":"Age-specific global epidemiology of hydrocephalus: systematic review, metanalysis and global birth surveillance","volume":"13","author":"Isaacs AM","year":"2018","unstructured":"Isaacs AM, Riva-Cambrin J, Yavin D, Hockley A, Pringsheim TM, Jette N,  Age-specific global epidemiology of hydrocephalus: systematic review, metanalysis and global birth surveillance. 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