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 Vol. 8 No. 3, September 2002
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AAP Grand Rounds 8:29-30 (2002)
© 2002 American Academy of Pediatrics

NEUROLOGICAL SURGERY

Cost-effectiveness of Alternative Treatments of Hydrocephalus in Childhood

Source: Garton HJL, Kestle JRW, Cochrane DD, et al. A cost-effectiveness analysis of endoscopic third ventriculostomy. Neurosurgery. 2002;51:69–78.[Medline]

The first 20% of the full text of this article appears below.

For 50 years the workhorse of the treatment of hydrocephalus has been the cerebrospinal fluid (CSF) shunt, a valve-regulated drain that diverts CSF from the central nervous system to another site where it can be reabsorbed into the vascular circulation at low pressure—most commonly the peritoneal cavity. The problems with CSF shunting are the infectious and mechanical complications, the management of which requires hospital admissions, surgical procedures, and the consumption of other resources. In the early 1990s, improvements in surgical instrumentation drove a resurgence of interest in an alternative treatment: endoscopic third ventriculostomy (ETV). ETV entails creation of a hole in the floor of the third ventricle to allow escape of CSF out of the ventricular cavities into the subarachnoid spaces where, presumably, it can be reabsorbed in the normal . . . [Full Text of this Article]

Joseph H. Piatt, Jr, MD, FAAP
Neurological Surgery and Pediatrics, Drexel University College of Medicine, St. Christopher’s Hospital for Children, Philadelphia, PA

 





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