{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T13:40:16Z","timestamp":1733492416899,"version":"3.30.1"},"reference-count":24,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Determining the long-term success of endoscopic third ventriculostomy (ETV) remains challenging. This study aimed to investigate the impact of clinical and radiological factors on ETV success in pediatric patients with hydrocephalus.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The study included patients &lt; 18 years old with hydrocephalus who underwent ETV between March 2014 and May 2021. Data including patient age, gender, history of previous shunt surgery, previous external ventricular drain placement, intraventricular hemorrhage history, and postoperative meningitis were extracted from medical records. Imaging features such as aqueductal stenosis, third ventricle floor bowing, displaced lamina terminalis, pulsatility index (PI), and maximum diameter of the cortical subarachnoid space (CSAS) were recorded for each patient using preoperative CT scans. Two independent neurosurgeons measured the CSAS maximum diameter and the PI. CSAS measurements were obtained on axial slices of the preoperative CT scans, whereas the PI was based on intraoperative third ventricle pulsatility. Patients were followed up for 1 year after surgery, with failure defined as the need for ventriculoperitoneal shunt (VPS) placement or death attributable to hydrocephalus.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Ninety-eight children with a mean age of 16.39 \u00b1 19.07 months underwent ETV for hydrocephalus. No deaths were recorded, but over 6 months and 1 year of follow-up, 12.2% and 22.4% of patients, respectively, experienced documented ETV failure requiring VPS placement. At the 6-month follow-up, a smaller maximum diameter of the CSAS was significantly associated with ETV failure; multivariate analysis revealed that CSAS maximum diameter was a predictor of 6-month ETV failure. At the 1-year follow-up, a lower PI was significantly associated with ETV failure, and multivariate analysis confirmed the PI as a significant predictor of ETV failure within 1 year after surgery. CSAS and PI measurements were repeated to assess interrater reliability: the intraclass correlation coefficients were 0.897 and 0.669 for CSAS and PI, respectively.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>This study found that the CSAS maximum diameter and the PI are predictors of ETV failure at 6 months and 1 year, respectively. These findings highlight the importance of considering specific factors such as the CSAS and PI when assessing the likelihood of ETV success in pediatric patients with hydrocephalus. Further research and consideration of these factors may help optimize patient selection and improve outcomes for those undergoing ETV as a treatment for hydrocephalus.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2024.6.peds23560","type":"journal-article","created":{"date-parts":[[2024,9,7]],"date-time":"2024-09-07T02:18:47Z","timestamp":1725675527000},"page":"432-437","source":"Crossref","is-referenced-by-count":0,"title":["Beyond traditional predictors: the impact of the pulsatility index and cortical subarachnoid space diameter on endoscopic third ventriculostomy success"],"prefix":"10.3171","volume":"34","author":[{"given":"Adrina","family":"Habibzadeh","sequence":"first","affiliation":[{"name":"Fasa University of Medical Sciences, Fasa;"},{"name":"USERN Office, Fasa University of Medical Sciences, Fasa;"},{"name":"Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sina","family":"Zoghi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz;"},{"name":"Shiraz University of Medical Sciences, Shiraz;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Ansari","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz;"},{"name":"Shiraz University of Medical Sciences, Shiraz;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sepehr","family":"Khademolhosseini","sequence":"additional","affiliation":[{"name":"Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad Sadegh","family":"Masoudi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Afrooz","family":"Feili","sequence":"additional","affiliation":[{"name":"Shiraz University of Medical Sciences, Shiraz;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omid","family":"Yousefi","sequence":"additional","affiliation":[{"name":"Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reza","family":"Taheri","sequence":"additional","affiliation":[{"name":"Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz; and"},{"name":"School of Medicine, Fasa University of Medical Sciences, Fasa, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"10020","key":"b1","series-title":"Lancet","first-page":"788","article-title":"Hydrocephalus in children","volume":"387","author":"Kahle KT","year":"2016","unstructured":"Kahle KT, Kulkarni AV, Limbrick DD Jr, Warf BC. Hydrocephalus in children. Lancet. 2016;387(10020):788\u2013799."},{"issue":"2","key":"b2","series-title":"J Pediatr","first-page":"254","article-title":"Endoscopic third ventriculostomy in the treatment of childhood hydrocephalus","volume":"155","author":"Kulkarni AV","year":"2009","unstructured":"Kulkarni AV, Drake JM, Mallucci CL, Sgouros S, Roth J, Constantini S. Endoscopic third ventriculostomy in the treatment of childhood hydrocephalus. J Pediatr. 2009;155(2):254\u2013259.e1."},{"issue":"1","key":"b3","series-title":"Surg Neurol","first-page":"5","article-title":"Success and complication rates of endoscopic third ventriculostomy for adult hydrocephalus: a series of 108 patients","volume":"69","author":"Dusick JR","year":"2008","unstructured":"Dusick JR, McArthur DL, Bergsneider M. Success and complication rates of endoscopic third ventriculostomy for adult hydrocephalus: a series of 108 patients. Surg Neurol. 2008;69(1):5\u201315."},{"issue":"4","key":"b4","series-title":"J Neurosurg Pediatr","first-page":"310","article-title":"Predicting who will benefit from endoscopic third ventriculostomy compared with shunt insertion in childhood hydrocephalus using the ETV Success Score","volume":"6","author":"Kulkarni AV","year":"2010","unstructured":"Kulkarni AV, Drake JM, Kestle JR, Mallucci CL, Sgouros S, Constantini S. Predicting who will benefit from endoscopic third ventriculostomy compared with shunt insertion in childhood hydrocephalus using the ETV Success Score. J Neurosurg Pediatr. 2010;6(4):310\u2013315."},{"issue":"6","key":"b5","series-title":"Neurosurg Rev","first-page":"1575","article-title":"Prediction of endoscopic third ventriculostomy (ETV) success with preoperative third ventricle floor bowing (TVFB): a supplement to ETV success score","volume":"43","author":"Wang Q","year":"2020","unstructured":"Wang Q, Cheng J, Zhang S, Li Q, Hui X, Ju Y. Prediction of endoscopic third ventriculostomy (ETV) success with preoperative third ventricle floor bowing (TVFB): a supplement to ETV success score. Neurosurg Rev. 2020;43(6):1575\u20131581."},{"key":"b6","series-title":"Clin Neurol Neurosurg","first-page":"107295","article-title":"Prediction of 6 months endoscopic third ventriculostomy success rate in patients with hydrocephalus using a multi-layer perceptron network","volume":"219","author":"Masoudi MS","year":"2022","unstructured":"Masoudi MS, Rezaei E, Tahmouresi A,  Prediction of 6 months endoscopic third ventriculostomy success rate in patients with hydrocephalus using a multi-layer perceptron network. Clin Neurol Neurosurg. 2022;219:107295."},{"issue":"6","key":"b7","series-title":"J Neurosurg","first-page":"1447","article-title":"Predicting success of endoscopic third ventriculostomy: validation of the ETV Success Score in a mixed population of adult and pediatric patients","volume":"123","author":"Labidi M","year":"2015","unstructured":"Labidi M, Lavoie P, Lapointe G,  Predicting success of endoscopic third ventriculostomy: validation of the ETV Success Score in a mixed population of adult and pediatric patients. J Neurosurg. 2015;123(6):1447\u20131455."},{"issue":"2","key":"b8","series-title":"J Neurosurg Pediatr","first-page":"182","article-title":"Preoperative third ventricular bowing as a predictor of endoscopic third ventriculostomy success","volume":"9","author":"Dlouhy BJ","year":"2012","unstructured":"Dlouhy BJ, Capuano AW, Madhavan K, Torner JC, Greenlee JD. Preoperative third ventricular bowing as a predictor of endoscopic third ventriculostomy success. J Neurosurg Pediatr. 2012;9(2):182\u2013190."},{"key":"b9","series-title":"Clin Neurol Neurosurg","first-page":"105554","article-title":"The role of third ventricle bowing in the success of endoscopic third ventriculostomy in pediatric and adult patients","volume":"187","author":"Krej\u010d\u00ed T","year":"2019","unstructured":"Krej\u010d\u00ed T, Krej\u010d\u00ed O, Ve\u010de\u0159a Z, Chlachula M, \u0160alounov\u00e1 D, Lipina R. The role of third ventricle bowing in the success of endoscopic third ventriculostomy in pediatric and adult patients. Clin Neurol Neurosurg. 2019;187:105554."},{"issue":"4","key":"b10","series-title":"Minim Invasive Neurosurg","first-page":"238","article-title":"Outcome prediction of third ventriculostomy: a proposed hydrocephalus grading system","volume":"49","author":"Kehler U","year":"2006","unstructured":"Kehler U, Regelsberger J, Gliemroth J, Westphal M. Outcome prediction of third ventriculostomy: a proposed hydrocephalus grading system. Minim Invasive Neurosurg. 2006;49(4):238\u2013243."},{"key":"b11","series-title":"Clin Neurol Neurosurg","first-page":"16","article-title":"Simplest radiological measurement related to clinical success in endoscopic third ventriculostomy","volume":"152","author":"B\u00f6rcek A\u00d6","year":"2017","unstructured":"B\u00f6rcek A\u00d6, U\u00e7ar M, Karaaslan B. Simplest radiological measurement related to clinical success in endoscopic third ventriculostomy. Clin Neurol Neurosurg. 2017;152:16\u201322."},{"issue":"3","key":"b12","series-title":"Acta Neurochir (Wien)","first-page":"247","article-title":"Transcranial Doppler-determined pulsatility index in the evaluation of endoscopic third ventriculostomy (preliminary data)","volume":"141","author":"Vajda Z","year":"1999","unstructured":"Vajda Z, B\u00fcki A, Vet\u00f6 F, Horv\u00e1th Z, S\u00e1ndor J, D\u00f3czi T. Transcranial Doppler-determined pulsatility index in the evaluation of endoscopic third ventriculostomy (preliminary data). Acta Neurochir (Wien). 1999;141(3):247\u2013250."},{"issue":"3","key":"b13","series-title":"J Korean Neurosurg Soc","first-page":"306","article-title":"Endoscopic third ventriculostomy: success and failure","volume":"60","author":"Deopujari CE","year":"2017","unstructured":"Deopujari CE, Karmarkar VS, Shaikh ST. Endoscopic third ventriculostomy: success and failure. J Korean Neurosurg Soc. 2017;60(3):306\u2013314."},{"issue":"1","key":"b14","series-title":"J Neurosurg Pediatr","first-page":"1","article-title":"The importance of the cortical subarachnoid space in understanding hydrocephalus","volume":"2","author":"Rekate HL","year":"2008","unstructured":"Rekate HL, Nadkarni TD, Wallace D. The importance of the cortical subarachnoid space in understanding hydrocephalus. J Neurosurg Pediatr. 2008;2(1):1\u201311."},{"issue":"2","key":"b15","series-title":"J Neurol Sci","first-page":"85","article-title":"Ventricular size in pseudotumor cerebri and the theory of impaired CSF absorption","volume":"177","author":"Levine DN","year":"2000","unstructured":"Levine DN. Ventricular size in pseudotumor cerebri and the theory of impaired CSF absorption. J Neurol Sci. 2000;177(2):85\u201394."},{"issue":"4","key":"b16","series-title":"Neurosurg Focus","first-page":"E6","article-title":"Longstanding overt ventriculomegaly in adults: pitfalls in treatment with endoscopic third ventriculostomy","volume":"22","author":"Rekate HL","year":"2007","unstructured":"Rekate HL. Longstanding overt ventriculomegaly in adults: pitfalls in treatment with endoscopic third ventriculostomy. Neurosurg Focus. 2007;22(4):E6."},{"issue":"3","key":"b17","series-title":"J Neurol Neurosurg Psychiatry","first-page":"385","article-title":"Changes in third ventricular size with neuroendoscopic third ventriculostomy: a blinded study","volume":"72","author":"Buxton N","year":"2002","unstructured":"Buxton N, Turner B, Ramli N, Vloeberghs M. Changes in third ventricular size with neuroendoscopic third ventriculostomy: a blinded study. J Neurol Neurosurg Psychiatry. 2002;72(3):385\u2013387."},{"issue":"1","key":"b18","series-title":"Neurosurgery","first-page":"104","article-title":"How effective is endoscopic third ventriculostomy in treating adult hydrocephalus caused by primary aqueductal stenosis?","volume":"46","author":"Tisell M","year":"2000","unstructured":"Tisell M, Almstr\u00f6m O, Stephensen H, Tullberg M, Wikkels\u00f6 C. How effective is endoscopic third ventriculostomy in treating adult hydrocephalus caused by primary aqueductal stenosis? Neurosurgery. 2000;46(1):104\u2013111."},{"issue":"4","key":"b19","series-title":"J Neurosurg Pediatr","first-page":"389","article-title":"Third ventricular shape: a predictor of endoscopic third ventriculostomy success in pediatric patients","volume":"7","author":"Foroughi M","year":"2011","unstructured":"Foroughi M, Wong A, Steinbok P, Singhal A, Sargent MA, Cochrane DD. Third ventricular shape: a predictor of endoscopic third ventriculostomy success in pediatric patients. J Neurosurg Pediatr. 2011;7(4):389\u2013396."},{"issue":"78th Meeting","key":"b20","series-title":"Trans Am Neurol Assoc","first-page":"49","article-title":"The arterial pulsation of the cerebrospinal fluid; its origin, configuration and possible clinical importance","volume":"3","author":"Bering EA","year":"1953","unstructured":"Bering EA, Ingraham FD. The arterial pulsation of the cerebrospinal fluid; its origin, configuration and possible clinical importance. Trans Am Neurol Assoc. 1953;3(78th Meeting):49\u201354."},{"issue":"1","key":"b21","series-title":"Fluids Barriers CNS","first-page":"5","article-title":"The pulsating brain: a review of experimental and clinical studies of intracranial pulsatility","volume":"8","author":"Wagshul ME","year":"2011","unstructured":"Wagshul ME, Eide PK, Madsen JR. The pulsating brain: a review of experimental and clinical studies of intracranial pulsatility. Fluids Barriers CNS. 2011;8(1):5."},{"issue":"5","key":"b22","series-title":"Childs Nerv Syst","first-page":"487","article-title":"Paradigm shift in hydrocephalus research in legacy of Dandy\u2019s pioneering work: rationale for third ventriculostomy in communicating hydrocephalus","volume":"23","author":"Greitz D","year":"2007","unstructured":"Greitz D. Paradigm shift in hydrocephalus research in legacy of Dandy\u2019s pioneering work: rationale for third ventriculostomy in communicating hydrocephalus. Childs Nerv Syst. 2007;23(5):487\u2013489."},{"issue":"5","key":"b23","series-title":"Can J Neurol Sci","first-page":"643","article-title":"Cine phase-contrast MR images failed to predict clinical outcome following ETV","volume":"36","author":"Di X","year":"2009","unstructured":"Di X, Ragab M, Luciano MG. Cine phase-contrast MR images failed to predict clinical outcome following ETV. Can J Neurol Sci. 2009;36(5):643\u2013647."},{"issue":"4","key":"b24","series-title":"J Neurosurg","first-page":"1107","article-title":"Epidemiology of central nervous system infectious diseases: a meta-analysis and systematic review with implications for neurosurgeons worldwide","volume":"130","author":"Robertson FC","year":"2018","unstructured":"Robertson FC, Lepard JR, Mekary RA,  Epidemiology of central nervous system infectious diseases: a meta-analysis and systematic review with implications for neurosurgeons worldwide. 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