Beyond traditional predictors: the impact of the pulsatility index and cortical subarachnoid space diameter on endoscopic third ventriculostomy success

内镜第三脑室造瘘术 医学 脑积水 第三脑室 脑室造瘘术 导水管狭窄 蛛网膜下腔 蛛网膜下腔出血 外科 室外引流 分流(医疗) 脑脊液 内科学
作者
Adrina Habibzadeh,Sina Zoghi,Ali Ansari,Sepehr Khademolhosseini,Mohammad Sadegh Masoudi,Afrooz Feili,Omid Yousefi,Reza Taheri
出处
期刊:Journal of neurosurgery [Journal of Neurosurgery Publishing Group]
卷期号:: 1-6
标识
DOI:10.3171/2024.6.peds23560
摘要

OBJECTIVE 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. METHODS The study included patients < 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. RESULTS Ninety-eight children with a mean age of 16.39 ± 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. CONCLUSIONS 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.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
与共发布了新的文献求助10
刚刚
苑阿宇完成签到 ,获得积分10
刚刚
yck1027完成签到,获得积分10
1秒前
fatcat完成签到,获得积分10
1秒前
斯文败类应助Camus采纳,获得10
2秒前
4秒前
Tammy完成签到 ,获得积分10
4秒前
Herisland完成签到 ,获得积分10
6秒前
lulalula完成签到,获得积分10
7秒前
NEO完成签到 ,获得积分10
9秒前
zcydbttj2011完成签到 ,获得积分10
11秒前
温暖的小鸭子完成签到,获得积分10
13秒前
17秒前
王泽厚发布了新的文献求助20
18秒前
雪花发布了新的文献求助10
20秒前
周全完成签到 ,获得积分10
24秒前
water应助科研通管家采纳,获得10
25秒前
Owen应助科研通管家采纳,获得10
25秒前
内向忆南完成签到,获得积分10
28秒前
翱翔者完成签到 ,获得积分10
31秒前
kryptonite完成签到 ,获得积分10
31秒前
月军完成签到,获得积分10
32秒前
欢呼寻冬完成签到 ,获得积分10
33秒前
西安浴日光能赵炜完成签到,获得积分10
34秒前
Joy完成签到 ,获得积分10
35秒前
Olsters完成签到 ,获得积分10
38秒前
老程完成签到,获得积分10
39秒前
zyb完成签到 ,获得积分10
42秒前
laber完成签到,获得积分0
42秒前
yue完成签到,获得积分10
42秒前
与共完成签到 ,获得积分10
45秒前
量子星尘发布了新的文献求助10
46秒前
gzf完成签到 ,获得积分10
47秒前
47秒前
D调的华丽完成签到,获得积分10
51秒前
xingxinghan完成签到 ,获得积分10
51秒前
ColinWine完成签到 ,获得积分10
54秒前
mix完成签到,获得积分10
54秒前
动听的谷秋完成签到 ,获得积分10
55秒前
刻苦努力的火龙果完成签到,获得积分10
56秒前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Handbook of Industrial Diamonds.Vol2 1100
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038066
求助须知:如何正确求助?哪些是违规求助? 3575779
关于积分的说明 11373801
捐赠科研通 3305584
什么是DOI,文献DOI怎么找? 1819239
邀请新用户注册赠送积分活动 892655
科研通“疑难数据库(出版商)”最低求助积分说明 815022