Journal of neurosurgery. Pediatrics最新文献

{"title":"Letter to the Editor. Gender disparity: batten down the hatches, fair winds and following seas!","authors":"Noor Ul Huda Maria, Noor Ul Ain Fatima, Qurrat Ul Ain Siddiq","doi":"10.3171/2024.12.PEDS24612","DOIUrl":"https://doi.org/10.3171/2024.12.PEDS24612","url":null,"abstract":"","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-2"},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal management of hydrocephalus in children with posterior fossa tumors: an international retrospective multicenter study.","authors":"Kasper Amund Henriksen, Arani Kulamurugan, Maia Poon, Harishchandra Lalgudi Srinivasan, Adam J Fleming, Sheila K Singh, Gorm Von Oettingen, Jane Skjøth-Rasmussen, Conor Mallucci, René Mathiasen, Jon Foss-Skiftesvik","doi":"10.3171/2024.12.PEDS24424","DOIUrl":"https://doi.org/10.3171/2024.12.PEDS24424","url":null,"abstract":"<p><strong>Objective: </strong>Hydrocephalus in children with posterior fossa tumors (PFTs) is commonly treated with extraventricular drain (EVD) placement, endoscopic third ventriculostomy (ETV), or tumor resection alone. However, the optimal treatment approach remains undetermined. Therefore, the objective of this study was to investigate the relationship between management of preoperative hydrocephalus in children with PFTs and the need for early postoperative CSF diversion and permanent drainage.</p><p><strong>Methods: </strong>This international multicenter retrospective cohort study included all pediatric patients (aged < 18 years) who underwent primary resection of a posterior fossa tumor at Alder Hey Children's Hospital, United Kingdom, 2008-2018; Rigshospitalet University Hospital, Denmark, 2011-2020; Aarhus University Hospital, Denmark, 2011-2020; and McMaster University Medical Centre, Canada, 2003-2020. The primary outcome was early postoperative CSF diversion (ETV, EVD, or shunt of any kind within 30 days of tumor resection). The secondary outcome was the permanent drainage (ventriculoperitoneal shunt) rate within 30 days after resection. Univariate and multivariate logistic regression analyses were performed.</p><p><strong>Results: </strong>In total, 310 children with PFTs were included, of whom 234 (75.5%) had preoperative hydrocephalus. Preoperative hydrocephalus was successfully treated in more than 85%. Thirty-eight children (12.3%) required permanent drainage, with a higher incidence in those treated with preoperative EVD. However, no statistically significant association was found between choice of preoperative hydrocephalus management (EVD vs ETV vs tumor resection alone) and persistent hydrocephalus requiring either early postoperative CSF diversion surgery or permanent CSF drainage.</p><p><strong>Conclusions: </strong>This large international multicenter study did not demonstrate a significant association between choice of management of preoperative hydrocephalus (EVD, ETV, or tumor resection alone) and persisting hydrocephalus requiring surgical intervention after tumor resection.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-7"},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The AANS/CNS Section on Pediatric Neurological Surgery domestic traveling fellowship: history and survey results of past recipients.","authors":"Eric M Thompson, Agnieszka Stadnik, Jason E Blatt, Edward S Ahn","doi":"10.3171/2024.11.PEDS24455","DOIUrl":"https://doi.org/10.3171/2024.11.PEDS24455","url":null,"abstract":"<p><strong>Objective: </strong>The American Association of Neurological Surgeons (AANS) and Congress of Neurological Surgeons (CNS) Section on Pediatric Neurological Surgery domestic traveling fellowship was created to cover the travel and living expenses for a North American neurosurgery resident for 1 month at another institution to gain experience in pediatric neurosurgery. The objective of this work was to guide future direction by surveying past recipients about the fellowship and its impact on their training and career.</p><p><strong>Methods: </strong>Historical data have been maintained by the AANS/CNS Executive Committee and past and current chairs of the Traveling Fellowship Subcommittee. A 10-question REDCap survey was emailed to all previous fellowship recipients.</p><p><strong>Results: </strong>There have been 58 recipients of the traveling fellowship since 1998. The most common host program was Boston Children's Hospital (n = 21), followed by The Hospital for Sick Children (n = 12). Excluding recent recipients after 2017 who may still be working toward certification, 20 of 38 (53%) recipients have been certified by the American Board of Pediatric Neurological Surgery (ABPNS). Twenty-four of 49 (49%) recipients completed the survey. Twenty (83.3%) respondents were either ABPNS certified or planning to seek certification, 17 (70.8%) respondents' practices consisted of > 50% patients aged ≤ 21 years, and 18 (75%) spent 4-8 weeks at the host program, which was longer than the 1 month funded by the stipend. Twenty-two (91.7%) respondents would recommend the traveling fellowship to a resident interested in pediatric neurosurgery, and 18 (75%) believed the traveling fellowship helped them decide to pursue a career in pediatric neurosurgery, while 17 (70.8%) found that the professional connections they made were the most useful aspect of the fellowship. Fifteen (62.5%) respondents believed that the stipend of $2500 was inadequate to cover the cost of traveling and housing.</p><p><strong>Conclusions: </strong>The majority of respondents are currently practicing pediatric neurosurgeons, would recommend the traveling fellowship to residents interested in neurosurgery, and believed that the experience helped them decide to pursue a career in pediatric neurosurgery. Opportunities for improvement include increasing the stipend to more appropriately fund rotations that have mostly been longer than 1 month.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-7"},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal timing of endoscopic sagittal suturectomy.","authors":"Patrick F O'Brien, Saige A Teti, Callum Dewar, Kristen Stabingas, Md Sohel Rana, Suresh N Magge, Daniel A Donoho, Hasan R Syed, Chima Oluigbo, John S Myseros, Gary F Rogers, Robert F Keating","doi":"10.3171/2024.11.PEDS24272","DOIUrl":"https://doi.org/10.3171/2024.11.PEDS24272","url":null,"abstract":"<p><strong>Objective: </strong>Endoscopic sagittal suturectomy (ESS) is commonly offered for sagittal craniosynostosis in infants, but the optimal timing of surgery remains controversial, with many clinicians only offering ESS surgery before 3 months of age. This study investigated whether patient age predicts craniometric correction and, more specifically, whether patients > 3 months of age at surgery manifest less correction. The effects of age on blood transfusion were also investigated.</p><p><strong>Methods: </strong>A single-center retrospective review identifying patients with sagittal craniosynostosis who underwent ESS between 2009 and 2023 at Children's National Medical Center was performed. The authors stratified patients by age groups to compare outcomes and transfusion rates. Additionally, receiver operating characteristic (ROC) area under the curve (AUC) analysis was performed to identify optimal age cutoffs.</p><p><strong>Results: </strong>In total, 107 patients were included. Stratifying age group by 0-2 months, 2-3 months, and > 3 months revealed that the > 3-month age group was less likely to achieve the target cephalic index (CI) at the final follow-up (48.8% vs 61.5% vs 25.0%, p = 0.031) and had less mean percentage CI change at the 6-month follow-up (17% ± 8% vs 18% ± 8% vs 12% ± 6%, p = 0.011), helmet discontinuation (18% ± 9% vs 18% ± 8% vs 12% ± 6%, p = 0.008), 1-year follow-up (15% ± 9% vs 17% ± 7% vs 10% ± 7%, p = 0.005), and final follow-up (14% ± 9% vs 15% ± 7% vs 8% ± 7%, p = 0.004). There were no differences in outcomes between groups when stratified as 0-2 months versus > 2 months of age. The only difference in outcomes between groups when stratified as 0-3 months versus > 3 months of age was the mean percentage change in CI at helmet removal (18% ± 8% vs 15% ± 7%, p = 0.044). Patients requiring transfusion were likely to be younger (median age 2 vs 3 months, p = 0.028). ROC curve analysis identified an age cut-point of 3.75 months as optimal for achieving the target CI correction at the final follow-up (AUC 0.58) and 2.75 months for transfusion avoidance (AUC 0.65).</p><p><strong>Conclusions: </strong>Patients > 3 months of age may benefit from ESS for sagittal craniosynostosis. Further investigation is warranted to identify the optimal age for surgery and to investigate other variables influencing outcomes.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-6"},"PeriodicalIF":2.1,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor. The challenging management of traumatic cerebral venous sinus thrombosis in children.","authors":"Ioannis N Mavridis, Theodossios Birbilis","doi":"10.3171/2024.10.PEDS24546","DOIUrl":"https://doi.org/10.3171/2024.10.PEDS24546","url":null,"abstract":"","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1"},"PeriodicalIF":2.1,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor. Occipital bone mass for C1-2 intra-articular fusion.","authors":"Qiang Jian, Shuangzhu Yue, Tao Fan","doi":"10.3171/2024.8.PEDS24436","DOIUrl":"https://doi.org/10.3171/2024.8.PEDS24436","url":null,"abstract":"","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-2"},"PeriodicalIF":2.1,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morphology and outcomes in combined sagittal and unilateral coronal synostosis.","authors":"Damini Tandon, Jackson S Burton, Madeline Karsten, Gary B Skolnick, Sybill D Naidoo, Mark R Proctor, Matthew D Smyth, Kamlesh B Patel","doi":"10.3171/2024.10.PEDS24245","DOIUrl":"https://doi.org/10.3171/2024.10.PEDS24245","url":null,"abstract":"<p><strong>Objective: </strong>Combined sagittal and unilateral coronal synostosis is an uncommon multisuture synostosis. The objective of this study was to describe patient demographics, characterize craniofacial morphology, and report surgical outcomes for patients with combined sagittal and unilateral coronal synostosis undergoing surgical repair.</p><p><strong>Methods: </strong>This was a retrospective cohort study performed as a joint effort between two US pediatric tertiary care institutions. Between 2003 and 2021, 10 patients with combined sagittal and unilateral coronal synostosis who underwent surgical repair were identified. Open repair involved fronto-orbital advancement and calvarial remodeling. Endoscopic repair involved endoscopy-assisted strip craniectomy of fused sutures with subsequent helmet therapy until 12 months of age. Craniofacial morphology was characterized from CT scans with parameters including the cephalic index (CI), orbital index (OI) asymmetry, nasal tip deviation, chin deviation, and anterior cranial fossa area ratio (ACFR). All patients had preoperative CT scans, and postoperative CT scans were analyzed when performed. Demographics, operative details, and complications were obtained via chart review.</p><p><strong>Results: </strong>Patients were predominantly male (70%) with fusion of left coronal suture (80%). Four patients (40%) underwent open repair, and 6 patients (60%) underwent endoscopic repair. The median operation length was 87 minutes for endoscopic repair and 226 minutes for open repair. Two endoscopic patients (33%) and 2 open patients (50%) required blood transfusion. Four patients (3 endoscopic, 1 open) underwent secondary operations. Preoperatively (n = 10), patients had a median CI of 0.75, with OI asymmetry (median -35%), nasal tip (median 6.9°) and chin deviation (median 9.5°) contralateral to the involved coronal suture, and cranial base asymmetry (median ACFR 0.63). Postoperatively (n = 6), patients had improved CI (median CI 0.81), OI asymmetry (median -22%), chin deviation (median 5.1°), and cranial base asymmetry (median ACFR 0.75) but slightly worse nasal tip deviation (median 8.5°).</p><p><strong>Conclusions: </strong>Combined sagittal and unilateral coronal synostosis resembles its isolated component phenotypes. Open and endoscopic repairs are safe. Morphological parameters trended toward improvement postoperatively.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-7"},"PeriodicalIF":2.1,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Should pediatric patients with isolated skull fractures be admitted, transferred, or discharged from the emergency department, and what are the economic consequences? Original series, systematic review of the literature, and a proposed admission protocol.","authors":"Ido Ben Zvi, Galal Imtiaz, Rory J Piper, Martin M Tisdall","doi":"10.3171/2024.11.PEDS24279","DOIUrl":"https://doi.org/10.3171/2024.11.PEDS24279","url":null,"abstract":"<p><strong>Objective: </strong>Pediatric head trauma is a common reason for emergency department (ED) referrals. Skull fractures are the most common imaging findings in the setting of pediatric trauma. Ample literature negates the necessity of hospitalization for neurologically intact children with isolated skull fractures (ISFs) and when nonaccidental injuries (NAIs) are not suspected. Despite this evidence, in many centers these children are still admitted for observation. The authors performed a retrospective analysis of the outcomes of children admitted with ISFs. A literature review of studies of children with ISFs was also performed. The objective of this study was to assess the necessity of admission of children with ISF.</p><p><strong>Methods: </strong>A retrospective single-center analysis was performed, based on the electronic referral database of a tertiary pediatric hospital. Pediatric patients (< 18 years old) with a linear skull fracture on CT were included. Patients with additional traumatic intracranial findings on imaging (bleeding, pneumocephalus, edema, etc.) were excluded, as were patients with depressed, open, or displaced fractures. A systematic literature review of the Medline and PubMed databases was performed.</p><p><strong>Results: </strong>Two hundred fifty-eight children met the criteria between 2019 and 2022. Eighty-one percent sustained a fall. Other mechanisms of injury included blunt-force trauma and road accidents, and 10.5% had an unclear mechanism. Most children had parietal fractures (56.3%), followed by occipital fractures and others. Sixteen percent suffered from chronic illnesses. No cases of growing skull fractures were noted. None of the children needed neurosurgical intervention. Moreover, none needed a follow-up CT scan. Three patients were transferred from a first-tier hospital to the authors' institution, none because of neurosurgical concerns. Other than these 3 patients, all other children were admitted to a pediatric ward for 24-hour observation and subsequently discharged. NAI was highly suspected in 7.1% of children (3/42) suffering from chronic illnesses as opposed to 1.4% (3/216) of healthy children. This difference was not statistically significant (p = 0.056). The literature review yielded 680 papers. After screening for relevance, language, etc., 8 original series with 5823 patients remained. One patient (0.017%) was operated on, but probably not for ISF. The cost difference between discharge from the ED and admission ranged between $520 and $4291 (US dollars). None of the children discharged from the ED returned for hospitalization.</p><p><strong>Conclusions: </strong>In this original cohort, none of the children had a change in management following their admission. None needed neurosurgical intervention. In children with linear ISFs, a short ED observation should be considered, followed by discharge based on neurological status. A proposed ED discharge protocol is presented.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-7"},"PeriodicalIF":2.1,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of reoperation following failed laser ablation surgery for epilepsy in pediatric patients.","authors":"Nunthasiri Wittayanakorn, Georgia M Wong, Saige A Teti, Veronica D Linan-Martinez, Haris Qamar, Nathan T Cohen, William D Gaillard, Chima O Oluigbo","doi":"10.3171/2024.11.PEDS24410","DOIUrl":"https://doi.org/10.3171/2024.11.PEDS24410","url":null,"abstract":"<p><strong>Objective: </strong>There are significant challenges in the surgical management of pharmacoresistant epilepsy. Laser interstitial thermal therapy (LITT) has emerged as a less invasive alternative to resection. However, seizure persistence or recurrence following LITT is not uncommon, and there is currently a lack of guidance and consensus on the best way to manage seizure recurrence after LITT for different epilepsy etiologies in children, or for the use of LITT when open resection has left residual epileptogenic tissue. The objective of this study was to assess the outcomes of secondary epilepsy surgery after failed initial LITT.</p><p><strong>Methods: </strong>The authors performed a retrospective chart review of patients who underwent secondary epilepsy surgery after failed LITT at Children's National Hospital.</p><p><strong>Results: </strong>A total of 36 patients were treated with LITT, and 4 were excluded due to the palliative purpose of LITT. Thirteen of 32 patients (40.6.%) achieved Engel I, 1 patient (3.1%) achieved Engel II, and 18 patients (56.2%) had poor outcomes (Engel III-IV). Of these 32 patients, 9 (28.1%) underwent reoperation after their first laser ablation surgery due to a recurrence of epilepsy. Seven patients had a second laser ablation, and 2 patients underwent open resection. Of these 9 patients, 3 (33.3%) had Engel I outcomes, and 6 (66.7%) had poor seizure outcomes (Engel III-IV). When considering only patients who had repeat LITT for reoperation, 2 of 7 (28.6%) of these patients achieved seizure freedom (Engel I). Of the 32 patients, short-term complications were transient oculomotor (n = 1, 3.1%) or trochlear (n = 1, 3.1%) nerve deficit, which entirely resolved within 6 months, and superior quadrantanopia (n = 1, 3.1%) after initial LITT.</p><p><strong>Conclusions: </strong>Although LITT has shown promising results in treating pharmacoresistant epilepsy, the recurrence of seizures necessitates further evaluation and consideration of reoperation, which may result in seizure freedom. Repeat LITT is a low-risk option for secondary surgery after seizure recurrence.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-10"},"PeriodicalIF":2.1,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reimagining durability of hydrocephalus treatment using conditional survival.","authors":"Aaron M Yengo-Kahn, John C Wellons, Hailey Jensen, Abhaya V Kulkarni, Jason K Chu, Jason S Hauptman, Albert M Isaacs, Eric M Jackson, Patrick J McDonald, Michael M McDowell, Ian F Pollack, Ron Reeder, Jay Riva-Cambrin, Brandon G Rocque, Jennifer M Strahle, Mandeep S Tamber, John R W Kestle","doi":"10.3171/2024.10.PEDS24454","DOIUrl":"https://doi.org/10.3171/2024.10.PEDS24454","url":null,"abstract":"<p><strong>Objective: </strong>Conditional survival incorporates the effect of time passed since an event to current data in an easy-to-understand, relevant format. Data from the Hydrocephalus Clinical Research Network (HCRN) registry were analyzed with conditional survival to improve patient and family counseling after hydrocephalus treatment.</p><p><strong>Methods: </strong>Children with hydrocephalus who underwent first-time treatment by a single proximal catheter ventriculoperitoneal shunt (VPS) or endoscopic third ventriculostomy (ETV) with or without choroid plexus cauterization with at least 3 years of follow-up in the prospective HCRN registry (14 sites, April 24, 2008-December 31, 2020) were included. Those with nonperitoneal or multiple proximal catheters were excluded. The probability of failure-free survival at 3, 5, and 10 years was calculated as a function of time since surgery.</p><p><strong>Results: </strong>Overall, 5782 patients were included (1609 with ETV, 4173 with VPS placement). The median time to censoring was 5.3 years. The overall respective 3-, 5-, and 10-year failure-free survival rates were 59%, 58%, and 57%, respectively, for ETV and 62%, 58%, and 54%, respectively, for VPS. If VPS failure had not occurred by 1 year postoperatively, the 3-, 5-, and 10-year failure-free survival rates were 85%, 79%, and 66%, respectively. If ETV failure had not occurred by 1 year, the 3-, 5-, and 10-year failure-free survival rates were 93%, 91%, and 86%, respectively. Conditional survival also varied by age and etiology.</p><p><strong>Conclusions: </strong>Patients who do not require revision surgery in the 1st year have an excellent chance of being revision free for an extended period. Conditional survival plots provided are intuitive and can be used in the counseling of North American patients with surgically treated hydrocephalus.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-11"},"PeriodicalIF":2.1,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}