• J Neurosurg Pediatr · Nov 2014

    Review Practice Guideline

    Pediatric hydrocephalus: systematic literature review and evidence-based guidelines. Part 4: Cerebrospinal fluid shunt or endoscopic third ventriculostomy for the treatment of hydrocephalus in children.

    • David D Limbrick, Lissa C Baird, Paul Klimo, Jay Riva-Cambrin, Ann Marie Flannery, and Pediatric Hydrocephalus Systematic Review and Evidence-Based Guidelines Task Force.
    • Division of Pediatric Neurosurgery, Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri
    • J Neurosurg Pediatr. 2014 Nov 1; 14 Suppl 1: 30-4.

    ObjectThe 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.MethodsBoth 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.ResultsOf 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.ConclusionsCerebrospinal fluid shunts and ETV demonstrated equivalent outcomes in the clinical etiologies studied.RecommendationBoth CSF shunts and ETV are options in the treatment of pediatric hydrocephalus.Strength Of RecommendationLevel II, moderate clinical certainty.

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