2018 AANS Annual Scientific Meeting-The Shunting Holy Grail: Decreasing Shunt Revisions

The Shunting Holy Grail: Decreasing Shunt Revisions

Video Transcription

Video Summary

Dr. Gernsback discusses decreasing shunt revisions in pediatric neurosurgery. Forty percent of shunts fail within the first year, making them highly error-prone. Dr. Gernsback explores alternatives to shunts, such as endoscopic third ventriculostomy (ETV), but acknowledges that not all patients are suitable for this procedure. He focuses on keeping the ventricles larger to decrease shunt revisions. By gradually increasing pressure in adjustable shunt valves, they artificially inflate the ventricle size while allowing brain development. They analyzed 81 children treated over eight years and found that adjustable shunt valves led to the fewest revisions. Older children and those without abdominal abnormalities were also less likely to need revisions. This single-institution study suggests the need for a multicenter prospective randomized trial.

Asset Caption

Joanna Elizabeth Gernsback, MD

Keywords

pediatric neurosurgery

shunt revisions

endoscopic third ventriculostomy

adjustable shunt valves

multicenter prospective randomized trial