TY - JOUR
T1 - Pediatric hydrocephalus
T2 - Systematic literature review and evidence-based guidelines. Part 4: Cerebrospinal fluid shunt or endoscopic third ventriculostomy for the treatment of hydrocephalus in children
AU - Limbrick, David D.
AU - Baird, Lissa C.
AU - Klimo, Paul
AU - Riva-Cambrin, Jay
AU - Flannery, Ann Marie
N1 - Funding Information:
Dr. Limbrick receives research funding through the National Institute of Neurological Disorders and Stroke. The systematic review and evidence-based guidelines were funded exclusively by the CNS and AANS Pediatric Section, which received no funding from outside commercial sources to support the development of this document.
Funding Information:
We acknowledge the American Association of Neurological Surgeons (AANS)/Congress of Neurological Surgeons (CNS) Joint Guide lines Committee for the members' reviews, comments, and suggestions; Laura Mitchell, Guidelines Project Manager for the CNS, for her contributions; Pamela Shaw, research librarian, for her assistance with the literature searches; Kevin Boyer for his assistance with data analysis; and Sue Ann Kawecki for her assistance with editing. Dr. Limbrick receives research funding through the National Institute of Neurological Disorders and Stroke. The systematic re view and evidence-based guidelines were funded exclusively by the CNS and AANS Pediatric Section, which received no funding from outside commercial sources to support the development of this document.
Publisher Copyright:
©AANS, 2014.
PY - 2014
Y1 - 2014
N2 - Object. The objective of this systematic review was to examine the existing literature comparing CSF shunts and endoscopic third ventriculostomy (ETV) for the treatment of pediatric hydrocephalus and to make evidence-based recommendations regarding the selection of surgical technique for this condition. Methods. Both the US National Library of Medicine and the Cochrane Database of Systematic Reviews were queried using MeSH headings and key words specifically chosen to identify published articles detailing the use of CSF shunts and ETV for the treatment of pediatric hydrocephalus. Articles meeting specific criteria that had been determined a priori were examined, and data were abstracted and compiled in evidentiary tables. These data were then analyzed by the Pediatric Hydrocephalus Systematic Review and Evidence-Based Guidelines Task Force to consider treatment recommendations based on the evidence. Results. Of the 122 articles identified using optimized search parameters, 52 were recalled for full-text review. One additional article, originally not retrieved in the search, was also reviewed. Fourteen articles met all study criteria and contained comparative data on CSF shunts and ETV. In total, 6 articles (1 Class II and 5 Class III) were accepted for inclusion in the evidentiary table; 8 articles were excluded for various reasons. The tabulated evidence supported the evaluation of CSF shunts versus ETV. Conclusions. Cerebrospinal fluid shunts and ETV demonstrated equivalent outcomes in the clinical etiologies studied. RECOMMENDATION: Both CSF shunts and ETV are options in the treatment of pediatric hydrocephalus. STRENGTH OF RECOMMENDATION: Level II, moderate clinical certainty.
AB - Object. The objective of this systematic review was to examine the existing literature comparing CSF shunts and endoscopic third ventriculostomy (ETV) for the treatment of pediatric hydrocephalus and to make evidence-based recommendations regarding the selection of surgical technique for this condition. Methods. Both the US National Library of Medicine and the Cochrane Database of Systematic Reviews were queried using MeSH headings and key words specifically chosen to identify published articles detailing the use of CSF shunts and ETV for the treatment of pediatric hydrocephalus. Articles meeting specific criteria that had been determined a priori were examined, and data were abstracted and compiled in evidentiary tables. These data were then analyzed by the Pediatric Hydrocephalus Systematic Review and Evidence-Based Guidelines Task Force to consider treatment recommendations based on the evidence. Results. Of the 122 articles identified using optimized search parameters, 52 were recalled for full-text review. One additional article, originally not retrieved in the search, was also reviewed. Fourteen articles met all study criteria and contained comparative data on CSF shunts and ETV. In total, 6 articles (1 Class II and 5 Class III) were accepted for inclusion in the evidentiary table; 8 articles were excluded for various reasons. The tabulated evidence supported the evaluation of CSF shunts versus ETV. Conclusions. Cerebrospinal fluid shunts and ETV demonstrated equivalent outcomes in the clinical etiologies studied. RECOMMENDATION: Both CSF shunts and ETV are options in the treatment of pediatric hydrocephalus. STRENGTH OF RECOMMENDATION: Level II, moderate clinical certainty.
KW - Cerebrospinal fluid
KW - Endoscopic third ventriculostomy
KW - Hydrocephalus
KW - Practice guidelines
KW - Shunt
KW - Ventriculoperitoneal
UR - http://www.scopus.com/inward/record.url?scp=84939421220&partnerID=8YFLogxK
U2 - 10.3171/2014.7.PEDS14324
DO - 10.3171/2014.7.PEDS14324
M3 - Review article
C2 - 25988780
AN - SCOPUS:84939421220
SN - 1933-0707
VL - 14
SP - 30
EP - 34
JO - Journal of Neurosurgery: Pediatrics
JF - Journal of Neurosurgery: Pediatrics
ER -