Neonatal postinfectious hydrocephalus (PIH) is a major public health problem in East Africa.The standard treatment has long been placement of a ventriculoperitoneal shunt (VPS) but these devices require life-long maintenance and nearly all fail multiple times. Endoscopic Third Ventriculostomy (ETV) with Choroid Plexus Cauterization (ETV/CPC) is an alternate treatment to give patients a shunt-free life. In this study, the investigators aim to optimize the metrics of evaluation as quantitative prognostic indicators of treatment response and long term outcomes.
Study Type
OBSERVATIONAL
Enrollment
400
The Endoscopic Third Ventriculostomy/Choroid Plexus Cauterization (ETV/CPC) will comprise a standard frontal approach with flexible endoscopy.
Penn State University
University Park, Pennsylvania, United States
ACTIVE_NOT_RECRUITINGThe Hospital for Sick Children
Toronto, Ontario, Canada
ACTIVE_NOT_RECRUITINGCure Children's Hospital of Uganda
Mbale, Uganda
RECRUITINGBayley Scales of Infant Development, Third Edition (BSID-3), cognitive scaled score
Scores on the BSID-3, which is used to evaluate infants and toddlers 1 to 42 months of age, range from 1 to 19, with higher scores indicating better performance; the mean (±standard deviation(SD)) score in the general population is 10±3.
Time frame: 24 months of age
Incidence of ETV/CPC treatment failure
Treatment failure or success will be determined with the use of clinical and radiographic criteria. * Treatment success will be determined as the shift in the growth of head circumference to a normal rate, as plotted on a standard growth chart; decompression of the anterior fontanel; relief of symptoms of elevated intracranial pressure, such as irritability and vomiting; resolution of down-gaze or sixth cranial nerve palsy; and a decrease or arrest in ventriculomegaly as determined on Computerized Tomography (CT). * Treatment failure will be defined as treatment-related death or the need for a second operation for infection or for the recurrence of hydrocephalus.
Time frame: 6 months post-treatment
Cerebral oxygen metabolism
cerebral oxygen metabolism will be measured with near-infrared spectroscopy
Time frame: pre- and post-, 6, 12 months post-treatment and 24 months of age
brain volume
brain volume will be quantitatively estimated from the head CT scan
Time frame: pre-, 6, 12 months post-treatment and 24 months of age
Bayley Scales of Infant Development, Third Edition (BSID-3), cognitive scaled score at 12 months post-treatment
Scores on the BSID-3, which is used to evaluate infants and toddlers 1 to 42 months of age, range from 1 to 19, with higher scores indicating better performance; the mean (±standard deviation) score in the general population is 10±3.
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Time frame: 12 months post-treatment