hcph

Question 1

shunt or ETV?

Answer 1

1. AGE?
   under 1 mo -0%
   1 - 6 mo -10%
   6mo-1year - 20%
   1y - 10 y - 40%
   over 10 y - 50%
2. Type of hcph?
   * post infectious - 0%
   * MMC, non-tectal tumor, post IVH - 20%
   * aq-stenosis, tectal tumor - 30%
3. Previous shunt?
   yes - 0%
   no - 10%

Question 2

The ETV success score is validated for predicting chance of success 6 months after ETV surgery. What does it mean to score 40% or less on the scale?

Answer 2

It means a very low chance of success.

Question 3

What does it mean to have a score over 80% in the ETV success score?

Answer 3

A better chance to succeed with ETV than shunting from the outset.

Question 4

What does scores of 41-79% on the ETV success score scale mean?

Answer 4

Higher initial failure rate compared to shunting, but after 3-6 mo the balance shifts toward ETV.

Question 5

What is the overall successrate for ETV in non-tumoral aqueduct stenosis pt?

Answer 5

60-94%.

Question 6

What does the score implicate for a 1 yo child without previous shunt and symtoms from an aqueduct stenosis?

Answer 6

It means 80% score and a better chance with ETV than shunting in the first trial.

Question 7

If an 11 yo girl with non-tectal tumor creating hcph - what should be shoosen?

Answer 7

80% score on ETV success score (50%+20%+10%) - ETV better than shunt.

Question 8

9 yo girl with non-tectal tumor creating hcph?

Answer 8

70% score. Risky first 4 mo but if it works, then better chances with ETV than shunt, so if possible, try first with ETV.

Question 9

9 yo boy with that had to take out his shunt due to infection . He had his shunt because of MMC.

Answer 9

1. 40% + 20% = 60%
   or if the infection also created hcph
2. 40% + 0% = 40%

In this case I would try ETV and hope that the infection has not had any implication on that, mostly due to the risk of inserting a foreign material in the postinfected setting but also due to the positive prognostics of ETV after 4 months with scores between 41%-79%.