Therapeutic Tactics for Pediatric Hydrocephalus

Abstract

Since hydrocephalus is usually an exacerbating disease, we need to arrest the hydrocephalus by surgical treatments such as ventricular access devices, V-P shunts, and endoscopic third ventriculostomy(ETV)with or without choroid plexus cauterization. For a long time, V-P shunt has been the GOLD standard treatment for pediatric hydrocephalus. In recent years, although there are more and more reports on the usefulness of ETV ± CPC, its results are not completely superior to V-P shunt, and therefore, V-P shunt is expected to remain the gold standard treatment for pediatric hydrocephalus in the near future. Therefore, overcoming complications, such as shunt dysfunction and shunt infection, will continue to be important in V-P shunt. A recent clinical trial has shown that antibiotic-impregnated catheters are effective in preventing shunt infections, which is why the incidence of shunt infection is expected to decrease in the future. For pediatric hydrocephalus, it is important to establish and maintain a regular follow-up system, because shunt malfunction may occur even in the chronic postoperative period.