{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T11:44:15Z","timestamp":1792755855704,"version":"4.5.0"},"reference-count":14,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2008,11]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Shunt dependence is more dangerous for children in less developed countries. Combining endoscopic third ventriculostomy (ETV) with choroid plexus cauterization (CPC) was previously shown to treat hydrocephalus more effectively than ETV alone in infants &lt; 1 year of age. The goal of this prospective study was to evaluate the effectiveness of ETV-CPC as primary treatment of hydrocephalus in infants with myelomeningocele.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>One hundred fifteen consecutive East African infants with myelomeningocele requiring treatment for hydrocephalus were intended for primary management using ETV-CPC. Patient information was prospectively entered into a database. Outcomes were evaluated by life table analysis. Potential predictors for treatment failure were evaluated using multivariate logistic regression.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Ninety-three patients had a completed ETV-CPC with &gt; 1 month of follow-up. The ETV-CPC procedure was successful in 71 patients (76%), with a mean and median follow-up of 19.0 months. Treatment failures occurred before 6 months in 86% of the patients, and none occurred after 10 months. The operative mortality rate was 1.1%, and there were no infections. Life table analysis suggested that 72% of the patients would be successfully treated using a single ETV-CPC and 78% would remain shunt-independent with reopening of a closed ETV stoma. Multivariate logistic regression showed scarring of the cistern (p = 0.021) or choroid plexus (p = 0.026) as predictors of failure, but age at the time of surgery was not a significant predictor.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Using ETV-CPC appears to successfully provide a more durable primary treatment of hydrocephalus for infants with spina bifida than does shunt placement. These results support ETV-CPC as the better treatment option for these children in developing countries.<\/jats:p><\/jats:sec>","DOI":"10.3171\/ped.2008.2.11.310","type":"journal-article","created":{"date-parts":[[2008,10,31]],"date-time":"2008-10-31T18:59:56Z","timestamp":1225479596000},"page":"310-316","source":"Crossref","is-referenced-by-count":189,"title":["Combined endoscopic third ventriculostomy and choroid plexus cauterization as primary treatment of hydrocephalus for infants with myelomeningocele: long-term results of a prospective intent-to-treat study in 115 East African infants"],"prefix":"10.3171","volume":"2","author":[{"given":"Benjamin C.","family":"Warf","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey W.","family":"Campbell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"2 Suppl","key":"b1-0020310","series-title":"J Neurosurg","first-page":"118","article-title":"Late rapid deterioration after endoscopic third ventriculostomy: additional cases and review of the literature","volume":"105","author":"Drake","year":"2006"},{"key":"b2-0020310","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1097\/00006123-199808000-00068","article-title":"Randomized trial of cerebrospinal fluid shunt valve design in pediatric hydrocephalus","volume":"43","author":"Drake","year":"1998"},{"key":"b3-0020310","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1007\/s00381-007-0303-z","article-title":"Paradigm shift in hydrocephalus research in legacy of Dandy's pioneering work: rationale for third ventriculostomy in communicating hydrocephalus","volume":"23","author":"Greitz","year":"2007"},{"key":"b4-0020310","series-title":"Clin Neurosurg","first-page":"48","article-title":"Cerebrospinal fluid pulsatility and hydrocephalus: the fourth circulation","volume":"53","author":"Madsen","year":"2006"},{"key":"b5-0020310","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1007\/s003810050192","article-title":"Outcome of patients with meningomyelocele: the Ege University experience","volume":"14","author":"Mirzai","year":"1998"},{"key":"b6-0020310","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1007\/s00381-005-0020-4","article-title":"Proposal of \u201cevolution theory in cerebrospinal fluid dynamics\u201d and minor pathway hydrocephalus in developing immature brain","volume":"22","author":"Oi","year":"2006"},{"issue":"6 Suppl","key":"b7-0020310","series-title":"J Neurosurg","first-page":"474","article-title":"Monte Carlo simulation of cerebrospinal fluid shunt failure and definition of instability among shunt-treated patients with hydrocephalus","volume":"107","author":"Piatt","year":"2007"},{"issue":"6 Suppl","key":"b8-0020310","series-title":"J Neurosurg","first-page":"448","article-title":"A mathematical model of survival in a newly inserted ventricular shunt","volume":"107","author":"Stein","year":"2007"},{"key":"b9-0020310","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1007\/BF00298448","article-title":"Long-term outcome and complications of children born with meningomyelocele","volume":"8","author":"Steinbok","year":"1992"},{"key":"b10-0020310","series-title":"Pediatr Neurosurg","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1159\/000121098","article-title":"Management of hydrocephalus by endoscopic third ventriculostomy in patients with myelomeningocele","volume":"25","author":"Teo","year":"1996"},{"key":"b11-0020310","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1007\/s00381-003-0759-4","article-title":"Long-term outcome of hydrocephalus management in myelomeningoceles","volume":"19","author":"Tuli","year":"2003"},{"issue":"1 Suppl","key":"b12-0020310","series-title":"J Neurosurg","first-page":"1","article-title":"Hydrocephalus in Uganda: predominance of infectious origin and primary management with endoscopic third ventriculostomy","volume":"102","author":"Warf","year":"2005"},{"issue":"6 Suppl Pediatrics","key":"b13-0020310","series-title":"J Neurosurg","first-page":"475","article-title":"Comparison of endoscopic third ventriculostomy alone and combined with choroid plexus cauterization in infants younger than 1 year of age: a prospective study in 550 African children","volume":"103","author":"Warf","year":"2005"},{"key":"b14-0020310","series-title":"Arab J Neurosurg","article-title":"Pediatric hydrocephalus in the developing world: connecting means and ends","author":"Warf","year":"2008"}],"container-title":["Journal of Neurosurgery: Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/2\/5\/article-p310.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/2\/5\/article-p310.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/2\/5\/article-p310.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T14:00:26Z","timestamp":1681567226000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/2\/5\/article-p310.xml"}},"subtitle":["Clinical article"],"short-title":[],"issued":{"date-parts":[[2008,11]]},"references-count":14,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3171\/ped.2008.2.11.310","relation":{},"ISSN":["1933-0707","1933-0715"],"issn-type":[{"value":"1933-0707","type":"print"},{"value":"1933-0715","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,11]]}}}