Comparing the Efficiency of Two Treatment Methods of Hydrocephalus: Shunt Implantation and Endoscopic Third Ventriculostomy
Introduction: Hydrocephalus is one of the most common diseases in children, and its treatment requires brain operation. However, the pathophysiology of the disease is very complicated and still unknown. Methods: Endoscopic Third Ventriculostomy (ETV) and Ventriculoperitoneal Shunt (VPS) implantatio...
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| Format: | Article |
| Language: | English |
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Iran University of Medical Sciences
2019-05-01
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| Series: | Basic and Clinical Neuroscience |
| Subjects: | |
| Online Access: | http://bcn.iums.ac.ir/article-1-1199-en.html |
| _version_ | 1827331748867866624 |
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| author | Seifollah Gholampour Mehrnoush Bahmani Azadeh Shariati |
| author_facet | Seifollah Gholampour Mehrnoush Bahmani Azadeh Shariati |
| author_sort | Seifollah Gholampour |
| collection | DOAJ |
| description | Introduction: Hydrocephalus is one of the most common diseases in children, and its treatment requires brain operation. However, the pathophysiology of the disease is very complicated and still unknown.
Methods: Endoscopic Third Ventriculostomy (ETV) and Ventriculoperitoneal Shunt (VPS) implantation are among the common treatments of hydrocephalus. In this study, Cerebrospinal Fluid (CSF) hydrodynamic parameters and efficiency of the treatment methods were compared with numerical simulation and clinical follow-up of the treated patients.
Results: Studies have shown that in patients under 19 years of age suffering from hydrocephalus related to a Posterior Fossa Brain Tumor (PFBT), the cumulative failure rate was 21% and 29% in ETV and VPS operation, respectively. At first, the ETV survival curve shows a sharp decrease and after two months it gets fixed while VPS curve makes a gradual decrease and reaches to a level lower than ETV curve after 5.7 months. Post-operative complications in ETV and VPS methods are 17% and 31%, respectively. In infants younger than 12 months with hydrocephalus due to congenital Aqueduct Stenosis (AS), and also in the elderly patients suffering from Normal Pressure Hydrocephalus (NPH), ETV is a better treatment option. Computer simulations show that the maximum CSF pressure is the most reliable hydrodynamic index for the evaluation of the treatment efficacy in these patients. After treatment by ETV and shunt methods, CSF pressure decreases about 9 and 5.3 times, respectively and 2.5 years after shunt implantation, this number returns to normal range.
Conclusion: In infants with hydrocephalus, initial treatment by ETV was more reasonable than implanting the shunt. In adult with hydrocephalus, the initial failure in ETV occurred sooner compared to shunt therapy; however, ETV was more efficient. |
| first_indexed | 2024-03-07T16:43:48Z |
| format | Article |
| id | doaj.art-e0c3060334c34dc09d99df54704a4651 |
| institution | Directory Open Access Journal |
| issn | 2008-126X 2228-7442 |
| language | English |
| last_indexed | 2024-03-07T16:43:48Z |
| publishDate | 2019-05-01 |
| publisher | Iran University of Medical Sciences |
| record_format | Article |
| series | Basic and Clinical Neuroscience |
| spelling | doaj.art-e0c3060334c34dc09d99df54704a46512024-03-03T07:15:18ZengIran University of Medical SciencesBasic and Clinical Neuroscience2008-126X2228-74422019-05-01103185198Comparing the Efficiency of Two Treatment Methods of Hydrocephalus: Shunt Implantation and Endoscopic Third VentriculostomySeifollah Gholampour0Mehrnoush Bahmani1Azadeh Shariati2 Department of Biomedical Engineering, Faculty of Electrical & Computer Engineering, Tehran North Branch, Islamic Azad University, Tehran, Iran. Department of Biomedical Engineering, Faculty of Electrical & Computer Engineering, Tehran North Branch, Islamic Azad University, Tehran, Iran. Department of Biomedical Engineering, Faculty of Electrical & Computer Engineering, Tehran North Branch, Islamic Azad University, Tehran, Iran. Introduction: Hydrocephalus is one of the most common diseases in children, and its treatment requires brain operation. However, the pathophysiology of the disease is very complicated and still unknown. Methods: Endoscopic Third Ventriculostomy (ETV) and Ventriculoperitoneal Shunt (VPS) implantation are among the common treatments of hydrocephalus. In this study, Cerebrospinal Fluid (CSF) hydrodynamic parameters and efficiency of the treatment methods were compared with numerical simulation and clinical follow-up of the treated patients. Results: Studies have shown that in patients under 19 years of age suffering from hydrocephalus related to a Posterior Fossa Brain Tumor (PFBT), the cumulative failure rate was 21% and 29% in ETV and VPS operation, respectively. At first, the ETV survival curve shows a sharp decrease and after two months it gets fixed while VPS curve makes a gradual decrease and reaches to a level lower than ETV curve after 5.7 months. Post-operative complications in ETV and VPS methods are 17% and 31%, respectively. In infants younger than 12 months with hydrocephalus due to congenital Aqueduct Stenosis (AS), and also in the elderly patients suffering from Normal Pressure Hydrocephalus (NPH), ETV is a better treatment option. Computer simulations show that the maximum CSF pressure is the most reliable hydrodynamic index for the evaluation of the treatment efficacy in these patients. After treatment by ETV and shunt methods, CSF pressure decreases about 9 and 5.3 times, respectively and 2.5 years after shunt implantation, this number returns to normal range. Conclusion: In infants with hydrocephalus, initial treatment by ETV was more reasonable than implanting the shunt. In adult with hydrocephalus, the initial failure in ETV occurred sooner compared to shunt therapy; however, ETV was more efficient.http://bcn.iums.ac.ir/article-1-1199-en.htmlCerebrospinal FluidIntracranial PressureIntracranial complianceSurvival curveReynolds numberCSF velocity |
| spellingShingle | Seifollah Gholampour Mehrnoush Bahmani Azadeh Shariati Comparing the Efficiency of Two Treatment Methods of Hydrocephalus: Shunt Implantation and Endoscopic Third Ventriculostomy Basic and Clinical Neuroscience Cerebrospinal Fluid Intracranial Pressure Intracranial compliance Survival curve Reynolds number CSF velocity |
| title | Comparing the Efficiency of Two Treatment Methods of Hydrocephalus: Shunt Implantation and Endoscopic Third Ventriculostomy |
| title_full | Comparing the Efficiency of Two Treatment Methods of Hydrocephalus: Shunt Implantation and Endoscopic Third Ventriculostomy |
| title_fullStr | Comparing the Efficiency of Two Treatment Methods of Hydrocephalus: Shunt Implantation and Endoscopic Third Ventriculostomy |
| title_full_unstemmed | Comparing the Efficiency of Two Treatment Methods of Hydrocephalus: Shunt Implantation and Endoscopic Third Ventriculostomy |
| title_short | Comparing the Efficiency of Two Treatment Methods of Hydrocephalus: Shunt Implantation and Endoscopic Third Ventriculostomy |
| title_sort | comparing the efficiency of two treatment methods of hydrocephalus shunt implantation and endoscopic third ventriculostomy |
| topic | Cerebrospinal Fluid Intracranial Pressure Intracranial compliance Survival curve Reynolds number CSF velocity |
| url | http://bcn.iums.ac.ir/article-1-1199-en.html |
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