Materiały źródłowe

• #1 Hydrocephalus: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/1135286-overview

  Long-term outcome is related directly to the cause of hydrocephalus. […] Up to 50% of patients with large intraventricular hemorrhage develop permanent hydrocephalus requiring shunt. […] Following removal of a posterior fossa tumor in children, 20% develop permanent hydrocephalus requiring a shunt. The overall prognosis is related to type, location, and extent of surgical resection of the tumor. […] Satisfactory control was reported for medical treatment in 50% of hydrocephalic patients younger than 1 year who had stable vital signs, normal renal function, and no symptoms of elevated ICP.

• #2 Outcomes and prognostic factors of infantile acquired hydrocephalus: a single-center experience

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10207705/

  To assess the etiologies and adverse outcomes of infantile acquired hydrocephalus and predict prognosis. […] Late surgical treatment times and severe ventricular dilation can predict adverse outcomes in infants with acquired hydrocephalus. It is crucial to identify the causes of acquired hydrocephalus to predict the adverse outcomes. […] A significant difference in adverse outcomes between the inherited error of metabolism as a cause and other etiologies (P=0.02). […] The combination of surgical intervention time and cranial ultrasonography (cUS) indices was a better predictive marker compared with any of them (surgical intervention time, P=0.05; cUS indices, P=0.002). […] A cutoff point of 13 days was determined for surgical intervention time, with a sensitivity of 0.77 and specificity of 0.72.

• #3 Outcomes and prognostic factors of infantile acquired hydrocephalus: a single-center experience | BMC Pediatrics | Full Text

  https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-023-04034-w

  To assess the etiologies and adverse outcomes of infantile acquired hydrocephalus and predict prognosis. […] Late surgical treatment times and severe ventricular dilation can predict adverse outcomes in infants with acquired hydrocephalus. It is crucial to identify the causes of acquired hydrocephalus to predict the adverse outcomes. […] The combination of surgical intervention time and cranial ultrasonography (cUS) indices was a better predictive marker compared with any of them (surgical intervention time, P=0.05; cUS indices, P=0.002). […] A significant difference in adverse outcomes between the inherited error of metabolism as a cause and other etiologies (P=0.02). […] This study provides a comprehensive analysis of the prognostic factors related to infant hydrocephalus, as evaluated at our center over the last 12 years. We found that PHH had a relatively favorable outcome compared with other etiologies except for the influences of prematurity and hemorrhage combined with meningitis. Late surgical intervention time and severe ventricular dilation have relatively adverse outcomes. Further research to reduce the incidence and severity of hydrocephalus in infants and improve their subsequent neurodevelopmental outcomes is urgently needed.

• #4 Outcomes and prognostic factors of infantile acquired hydrocephalus: a single-center experience

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10207705/

  This study provides a comprehensive analysis of the prognostic factors related to infant hydrocephalus, as evaluated at our center over the last 12 years. We found that PHH had a relatively favorable outcome compared with other etiologies except for the influences of prematurity and hemorrhage combined with meningitis. Late surgical intervention time and severe ventricular dilation have relatively adverse outcomes. Further research to reduce the incidence and severity of hydrocephalus in infants and improve their subsequent neurodevelopmental outcomes is urgently needed.

• #5 Outcomes and prognostic factors of infantile acquired hydrocephalus: a single-center experience | BMC Pediatrics | Full Text

  https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-023-04034-w

  To assess the etiologies and adverse outcomes of infantile acquired hydrocephalus and predict prognosis. […] Late surgical treatment times and severe ventricular dilation can predict adverse outcomes in infants with acquired hydrocephalus. It is crucial to identify the causes of acquired hydrocephalus to predict the adverse outcomes. […] The combination of surgical intervention time and cranial ultrasonography (cUS) indices was a better predictive marker compared with any of them (surgical intervention time, P=0.05; cUS indices, P=0.002). […] A significant difference in adverse outcomes between the inherited error of metabolism as a cause and other etiologies (P=0.02). […] This study provides a comprehensive analysis of the prognostic factors related to infant hydrocephalus, as evaluated at our center over the last 12 years. We found that PHH had a relatively favorable outcome compared with other etiologies except for the influences of prematurity and hemorrhage combined with meningitis. Late surgical intervention time and severe ventricular dilation have relatively adverse outcomes. Further research to reduce the incidence and severity of hydrocephalus in infants and improve their subsequent neurodevelopmental outcomes is urgently needed.

• #6 Outcomes and prognostic factors of infantile acquired hydrocephalus: a single-center experience

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10207705/

  To assess the etiologies and adverse outcomes of infantile acquired hydrocephalus and predict prognosis. […] Late surgical treatment times and severe ventricular dilation can predict adverse outcomes in infants with acquired hydrocephalus. It is crucial to identify the causes of acquired hydrocephalus to predict the adverse outcomes. […] A significant difference in adverse outcomes between the inherited error of metabolism as a cause and other etiologies (P=0.02). […] The combination of surgical intervention time and cranial ultrasonography (cUS) indices was a better predictive marker compared with any of them (surgical intervention time, P=0.05; cUS indices, P=0.002). […] A cutoff point of 13 days was determined for surgical intervention time, with a sensitivity of 0.77 and specificity of 0.72.

• #7 Outcomes and prognostic factors of infantile acquired hydrocephalus: a single-center experience

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10207705/

  To assess the etiologies and adverse outcomes of infantile acquired hydrocephalus and predict prognosis. […] Late surgical treatment times and severe ventricular dilation can predict adverse outcomes in infants with acquired hydrocephalus. It is crucial to identify the causes of acquired hydrocephalus to predict the adverse outcomes. […] A significant difference in adverse outcomes between the inherited error of metabolism as a cause and other etiologies (P=0.02). […] The combination of surgical intervention time and cranial ultrasonography (cUS) indices was a better predictive marker compared with any of them (surgical intervention time, P=0.05; cUS indices, P=0.002). […] A cutoff point of 13 days was determined for surgical intervention time, with a sensitivity of 0.77 and specificity of 0.72.

• #8 Outcomes and prognostic factors of infantile acquired hydrocephalus: a single-center experience | BMC Pediatrics | Full Text

  https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-023-04034-w

  To assess the etiologies and adverse outcomes of infantile acquired hydrocephalus and predict prognosis. […] Late surgical treatment times and severe ventricular dilation can predict adverse outcomes in infants with acquired hydrocephalus. It is crucial to identify the causes of acquired hydrocephalus to predict the adverse outcomes. […] The combination of surgical intervention time and cranial ultrasonography (cUS) indices was a better predictive marker compared with any of them (surgical intervention time, P=0.05; cUS indices, P=0.002). […] A significant difference in adverse outcomes between the inherited error of metabolism as a cause and other etiologies (P=0.02). […] This study provides a comprehensive analysis of the prognostic factors related to infant hydrocephalus, as evaluated at our center over the last 12 years. We found that PHH had a relatively favorable outcome compared with other etiologies except for the influences of prematurity and hemorrhage combined with meningitis. Late surgical intervention time and severe ventricular dilation have relatively adverse outcomes. Further research to reduce the incidence and severity of hydrocephalus in infants and improve their subsequent neurodevelopmental outcomes is urgently needed.

• #9 Outcomes and prognostic factors of infantile acquired hydrocephalus: a single-center experience

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10207705/

  To assess the etiologies and adverse outcomes of infantile acquired hydrocephalus and predict prognosis. […] Late surgical treatment times and severe ventricular dilation can predict adverse outcomes in infants with acquired hydrocephalus. It is crucial to identify the causes of acquired hydrocephalus to predict the adverse outcomes. […] A significant difference in adverse outcomes between the inherited error of metabolism as a cause and other etiologies (P=0.02). […] The combination of surgical intervention time and cranial ultrasonography (cUS) indices was a better predictive marker compared with any of them (surgical intervention time, P=0.05; cUS indices, P=0.002). […] A cutoff point of 13 days was determined for surgical intervention time, with a sensitivity of 0.77 and specificity of 0.72.

• #10 Predictors of outcome in patients with normal-pressure hydrocephalus – PubMed

  https://pubmed.ncbi.nlm.nih.gov/12852885/

  Despite knowledge emerging over the last 40 years, the postoperative results after shunt implantation in patients diagnosed with normal-pressure hydrocephalus (NPH) have not improved significantly over the last decade. For that reason predictors have to be identified in order to preoperatively predict outcome. […] In our study, we focussed attention on the possible predictors: patients age, length of disease, clinical signs (gait ataxia, dementia and bladder incontinence), aetiology idiopathic/secondary as well as implanted valve type and the value of resistance to cerebrospinal fluid outflow. […] In 80 patients with an early stage NPH (without cerebral atrophy), a short course of disease (1 year), a slight degree of dementia and an implanted Miethke-Dual-Switch valve were significant predictors for a positive postoperative outcome. The outflow resistance measured in the intrathecal infusion test showed only a minimal relevance to outcome. Those 75 patients with a late state NPH (with cerebral atrophy) had a better outcome when dementia was not present, the outflow resistance was above 20mm Hg/min/ml, the CSF tap-test was positive and a Miethke-Dual-Switch valve was implanted.

• #11 Predictors of outcome in patients with normal-pressure hydrocephalus | SpringerLink

  https://link.springer.com/chapter/10.1007/3-211-30714-1_73

  From 1982 until 2000 we examined 200 patients diagnosed with normal-pressure hydrocephalus (NPH) in a prospective study. […] In our study, we focused on the possible predictors: patient age; length of disease; clinical signs including gait ataxia, dementia, and bladder incontinence; idiopathic vs. secondary origin; implanted valve type and the resistance of the valve to cerebrospinal fluid outflow. […] In 80 patients without cerebral atrophy and a short course of disease (1 year), a slight amount of dementia and an implanted Miethke Dualswitch-Valve were significant predictors for a positive postoperative outcome. […] Seventy-five patients with cerebral atrophy had a better outcome when dementia was not present, outflow resistance was above 20 mmHg/mL/min, the CSF tap-test was positive, and a Miethke Dualswitch-Valve was implanted.

• #12 Predictors of outcome in patients with normal-pressure hydrocephalus – PubMed

  https://pubmed.ncbi.nlm.nih.gov/12852885/

  Despite knowledge emerging over the last 40 years, the postoperative results after shunt implantation in patients diagnosed with normal-pressure hydrocephalus (NPH) have not improved significantly over the last decade. For that reason predictors have to be identified in order to preoperatively predict outcome. […] In our study, we focussed attention on the possible predictors: patients age, length of disease, clinical signs (gait ataxia, dementia and bladder incontinence), aetiology idiopathic/secondary as well as implanted valve type and the value of resistance to cerebrospinal fluid outflow. […] In 80 patients with an early stage NPH (without cerebral atrophy), a short course of disease (1 year), a slight degree of dementia and an implanted Miethke-Dual-Switch valve were significant predictors for a positive postoperative outcome. The outflow resistance measured in the intrathecal infusion test showed only a minimal relevance to outcome. Those 75 patients with a late state NPH (with cerebral atrophy) had a better outcome when dementia was not present, the outflow resistance was above 20mm Hg/min/ml, the CSF tap-test was positive and a Miethke-Dual-Switch valve was implanted.

• #13 Predictors of outcome in patients with normal-pressure hydrocephalus | SpringerLink

  https://link.springer.com/chapter/10.1007/3-211-30714-1_73

  From 1982 until 2000 we examined 200 patients diagnosed with normal-pressure hydrocephalus (NPH) in a prospective study. […] In our study, we focused on the possible predictors: patient age; length of disease; clinical signs including gait ataxia, dementia, and bladder incontinence; idiopathic vs. secondary origin; implanted valve type and the resistance of the valve to cerebrospinal fluid outflow. […] In 80 patients without cerebral atrophy and a short course of disease (1 year), a slight amount of dementia and an implanted Miethke Dualswitch-Valve were significant predictors for a positive postoperative outcome. […] Seventy-five patients with cerebral atrophy had a better outcome when dementia was not present, outflow resistance was above 20 mmHg/mL/min, the CSF tap-test was positive, and a Miethke Dualswitch-Valve was implanted.

• #14 Outcome predictors for normal-pressure hydrocephalus | SpringerLink

  https://link.springer.com/chapter/10.1007/3-211-30714-1_75

  The objective of this prospective study was to find outcome predictors for better selection for treatment of normal-pressure hydrocephalus (NPH) patients. […] In general, outcome became worse with increasing anamnesis duration, worse preoperative clinical state, and increasing comorbidity. […] If one of these parameters was lower than a critical value, the shunt-responder rate was about 90% and the normally negative influence of older age was not seen. […] The well-known paradigm of a worse prognosis with NPH is not the result of the hydrocephalus etiology itself, but the consequence of a typical accumulation of negative outcome predictors as a consequence of the misinterpretation of normal aging and delayed adequate treatment.

• #15 Survival After Shunt Therapy in Normal-Pressure Hydrocephalus: A Meta-Analysis of 1614 Patients

  https://www.mdpi.com/2035-8377/16/6/107

  Survival After Shunt Therapy in Normal-Pressure Hydrocephalus: A Meta-Analysis of 1614 Patients […] The natural history of NPH patients is characterized by a poor prognosis, markedly impairing quality of life and potentially reducing life expectancy. […] The median survival time in NPH patients treated with a VP shunt was 8.82 years (95% CI: 8.23–9.40). […] The HR for gait was 2.25 (95% CI: 1.81–2.81, p < 0.001). [...] The hazard ratio from the combined IPD for continence was 1.66 (95% CI: 1.33–2.06, p < 0.001). [...] The hazard ratio derived from the pooled IPD for mRS was 2.21 (95% CI: 1.74–2.80, p < 0.001). [...] Our findings support the proactive diagnostic and therapy of NPH patients in order to preserve their quality of life and prolong their life expectancy. The results highlight the impact of initial symptom severity on survival after VP shunt treatment in NPH patients. Early intervention in individuals with rigorous diagnosed NPH and without substantial comorbidities could potentially enhance their survival time.

• #16 Survival After Shunt Therapy in Normal-Pressure Hydrocephalus: A Meta-Analysis of 1614 Patients

  https://www.mdpi.com/2035-8377/16/6/107

  Survival After Shunt Therapy in Normal-Pressure Hydrocephalus: A Meta-Analysis of 1614 Patients […] The natural history of NPH patients is characterized by a poor prognosis, markedly impairing quality of life and potentially reducing life expectancy. […] The median survival time in NPH patients treated with a VP shunt was 8.82 years (95% CI: 8.23–9.40). […] The HR for gait was 2.25 (95% CI: 1.81–2.81, p < 0.001). [...] The hazard ratio from the combined IPD for continence was 1.66 (95% CI: 1.33–2.06, p < 0.001). [...] The hazard ratio derived from the pooled IPD for mRS was 2.21 (95% CI: 1.74–2.80, p < 0.001). [...] Our findings support the proactive diagnostic and therapy of NPH patients in order to preserve their quality of life and prolong their life expectancy. The results highlight the impact of initial symptom severity on survival after VP shunt treatment in NPH patients. Early intervention in individuals with rigorous diagnosed NPH and without substantial comorbidities could potentially enhance their survival time.

• #17 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Hydrocephalus-Prognosis.aspx

  The mortality rate for hydrocephalus and associated therapy ranges from 0 to 3%. This rate is highly dependent on the duration of follow-up care. The shunt event-free survival is approximately 70% at 12 months and is nearly half that at 10 years, post-operatively. […] The triad of early detection, prompt treatment, and taking the necessary steps to avoid surgical site infections is the cornerstone to ensuring a great long-term outlook. It particularly helps in reducing the chances of developing clinically significant neurological damage. Failure to catch hydrocephalus on time and treat it accordingly may lead to long-term neurological deficits that require multidisciplinary medical teams to assist patients with developmental and lasting cognitive impairment. Neurological damage that may have occurred prior to treatment is unfortunately irreversible and can have a significant impact on functional social outcomes such as social integration, schooling, and marriage.

• #18 Association between ventricular CSF biomarkers and outcome after shunt surgery in idiopathic normal pressure hydrocephalus | Fluids and Barriers of the CNS | Full Text

  https://fluidsbarrierscns.biomedcentral.com/articles/10.1186/s12987-023-00475-8

  The relationship between neurochemical changes and outcome after shunt surgery in idiopathic normal pressure hydrocephalus (iNPH), a treatable dementia and gait disorder, is unclear. […] A higher preoperative ventricular CSF level of neurogranin, which is a postsynaptic marker, may signal a favorable postoperative outcome. […] Concentrations of a panel of ventricular CSF biomarkers explained only 6% of the variability in outcome. […] Evidence of amyloid or tau pathology did not affect the outcome. […] The multivariate regression model including the three markers GFAP, neurogranin and, T-tau showed a weak correlation to outcome, explaining only 6% of the variance. […] This finding implies that other mechanisms not accounted for here are the key determinants for prediction of outcome and that the pathophysiological phenomena of astrogliosis, synaptic dysfunction and subcortical neuronal degeneration, signaled by changes in biomarker concentrations, play a minor role in moderating shunt response in patients. […] We conclude that evidence of amyloid pathology should not exclude patients from iNPH investigation or shunting, a notion supported by others. […] The role of vascular risk factors in iNPH remains to be further investigated.

• #19 Prediction of Surgical Outcomes in Normal Pressure Hydrocephalus by MR Elastography | American Journal of Neuroradiology

  http://www.ajnr.org/content/early/2024/01/25/ajnr.A8108

  Normal pressure hydrocephalus is a treatable cause of dementia associated with distinct mechanical property signatures in the brain as measured by MR elastography. […] We tested the hypothesis that summary measures of these mechanical signatures can be used to predict clinical outcomes. […] Both the 2D and 20D classifiers performed significantly better than chance for predicting clinical outcomes with estimated areas under the receiver operating characteristic curve of 0.66 and 0.77, respectively. […] MR elastography provides further insight into mechanical alterations in the normal pressure hydrocephalus brain and is a promising, noninvasive method for predicting surgical outcomes in patients with normal pressure hydrocephalus. […] Predicting the outcome of shunt surgery is a challenging task.

• #20 Association between ventricular CSF biomarkers and outcome after shunt surgery in idiopathic normal pressure hydrocephalus | Fluids and Barriers of the CNS | Full Text

  https://fluidsbarrierscns.biomedcentral.com/articles/10.1186/s12987-023-00475-8

  The relationship between neurochemical changes and outcome after shunt surgery in idiopathic normal pressure hydrocephalus (iNPH), a treatable dementia and gait disorder, is unclear. […] A higher preoperative ventricular CSF level of neurogranin, which is a postsynaptic marker, may signal a favorable postoperative outcome. […] Concentrations of a panel of ventricular CSF biomarkers explained only 6% of the variability in outcome. […] Evidence of amyloid or tau pathology did not affect the outcome. […] The multivariate regression model including the three markers GFAP, neurogranin and, T-tau showed a weak correlation to outcome, explaining only 6% of the variance. […] This finding implies that other mechanisms not accounted for here are the key determinants for prediction of outcome and that the pathophysiological phenomena of astrogliosis, synaptic dysfunction and subcortical neuronal degeneration, signaled by changes in biomarker concentrations, play a minor role in moderating shunt response in patients. […] We conclude that evidence of amyloid pathology should not exclude patients from iNPH investigation or shunting, a notion supported by others. […] The role of vascular risk factors in iNPH remains to be further investigated.

• #21 Prediction of Surgical Outcomes in Normal Pressure Hydrocephalus by MR Elastography | American Journal of Neuroradiology

  http://www.ajnr.org/content/early/2024/01/25/ajnr.A8108

  Normal pressure hydrocephalus is a treatable cause of dementia associated with distinct mechanical property signatures in the brain as measured by MR elastography. […] We tested the hypothesis that summary measures of these mechanical signatures can be used to predict clinical outcomes. […] Both the 2D and 20D classifiers performed significantly better than chance for predicting clinical outcomes with estimated areas under the receiver operating characteristic curve of 0.66 and 0.77, respectively. […] MR elastography provides further insight into mechanical alterations in the normal pressure hydrocephalus brain and is a promising, noninvasive method for predicting surgical outcomes in patients with normal pressure hydrocephalus. […] Predicting the outcome of shunt surgery is a challenging task.

• #22 Prediction of Surgical Outcomes in Normal Pressure Hydrocephalus by MR Elastography | American Journal of Neuroradiology

  http://www.ajnr.org/content/early/2024/01/25/ajnr.A8108

  The ability to predict negative outcomes is critical. […] In this study, we present a noninvasive machine learning approach based on MRE for predicting surgical outcomes in NPH that considers the spectrum of NPH imaging phenotypes and not just DESH. […] The 20D feature space improved predictions compared with the 2D feature space, indicating that a more detailed summary of the MRE result contains clinically useful information and merits further investigation. […] Pattern analysis based on MRE presents a promising method for improving diagnosis and prediction of shunt outcomes.

• #23 Vascular risk profiles for predicting outcome and long-term mortality in patients with idiopathic normal pressure hydrocephalus: comparison of clinical decision support tools in: Journal of Neurosurgery Volume 138 Issue 2 (2022) Journals

  https://thejns.org/view/journals/j-neurosurg/138/2/article-p476.xml

  Vascular risk factors (VRFs) may act synergistically, and clinical decision support tools (CDSTs) have been developed that present vascular risk as a summarized score. Because VRFs are a major issue in patients with idiopathic normal pressure hydrocephalus (INPH), a CDST may be useful in the diagnostic workup. The objective was to compare 4 CDSTs to determine which one most accurately predicts short-term outcome and 10-year mortality after CSF shunt surgery in INPH patients. […] For 3 CDSTs, increased score was associated with increased risk of 10-year mortality. A 1-point increase in the FRS indicated a 2% higher risk of death within 10 years (HR 1.02, 95% CI 1.0031.035, p = 0.021); SCORE-OP, 5% (HR 1.05, 95% CI 1.0191.087, p = 0.002); and KCI, 12% (HR 1.12, 95% CI 1.031.219, p = 0.008). FRS predicted short-term outcome of surgery (p = 0.024). When the cutoff value was set to 32.5%, the positive predictive value was 80% and the negative predictive value was 48% (p = 0.012).

• #24 Vascular risk profiles for predicting outcome and long-term mortality in patients with idiopathic normal pressure hydrocephalus: comparison of clinical decision support tools in: Journal of Neurosurgery Volume 138 Issue 2 (2022) Journals

  https://thejns.org/view/journals/j-neurosurg/138/2/article-p476.xml

  Vascular risk factors (VRFs) may act synergistically, and clinical decision support tools (CDSTs) have been developed that present vascular risk as a summarized score. Because VRFs are a major issue in patients with idiopathic normal pressure hydrocephalus (INPH), a CDST may be useful in the diagnostic workup. The objective was to compare 4 CDSTs to determine which one most accurately predicts short-term outcome and 10-year mortality after CSF shunt surgery in INPH patients. […] For 3 CDSTs, increased score was associated with increased risk of 10-year mortality. A 1-point increase in the FRS indicated a 2% higher risk of death within 10 years (HR 1.02, 95% CI 1.0031.035, p = 0.021); SCORE-OP, 5% (HR 1.05, 95% CI 1.0191.087, p = 0.002); and KCI, 12% (HR 1.12, 95% CI 1.031.219, p = 0.008). FRS predicted short-term outcome of surgery (p = 0.024). When the cutoff value was set to 32.5%, the positive predictive value was 80% and the negative predictive value was 48% (p = 0.012).

• #25 Vascular risk profiles for predicting outcome and long-term mortality in patients with idiopathic normal pressure hydrocephalus: comparison of clinical decision support tools in: Journal of Neurosurgery Volume 138 Issue 2 (2022) Journals

  https://thejns.org/view/journals/j-neurosurg/138/2/article-p476.xml

  The authors recommend using FRS to predict short-term outcome and 10-year risk of mortality in INPH patients. The study indicated that extensive treatment of the risk factors of INPH may decrease risk of mortality. […] The results indicated that FRS was the best CDST for INPH patients because FRS predicted both death within 10 years and short-term outcome of CSF shunt surgery. The study indicated that extensive treatment of the risk factors of INPH may decrease risk of mortality; therefore, further research is needed to implement CDSTs in clinical settings and to develop a CDST customized for INPH patients. […] FRS appears to be the best CDST for predicting both short-term outcome and 10-year risk of mortality in INPH patients. FRS could be used to guide optimal treatment and preoperative evaluations of INPH patients. The result of this study indicated that risk of mortality may decrease in INPH patients if the focus is treatment of risk factors.

• #26 Vascular risk profiles for predicting outcome and long-term mortality in patients with idiopathic normal pressure hydrocephalus: comparison of clinical decision support tools in: Journal of Neurosurgery Volume 138 Issue 2 (2022) Journals

  https://thejns.org/view/journals/j-neurosurg/138/2/article-p476.xml

  The authors recommend using FRS to predict short-term outcome and 10-year risk of mortality in INPH patients. The study indicated that extensive treatment of the risk factors of INPH may decrease risk of mortality. […] The results indicated that FRS was the best CDST for INPH patients because FRS predicted both death within 10 years and short-term outcome of CSF shunt surgery. The study indicated that extensive treatment of the risk factors of INPH may decrease risk of mortality; therefore, further research is needed to implement CDSTs in clinical settings and to develop a CDST customized for INPH patients. […] FRS appears to be the best CDST for predicting both short-term outcome and 10-year risk of mortality in INPH patients. FRS could be used to guide optimal treatment and preoperative evaluations of INPH patients. The result of this study indicated that risk of mortality may decrease in INPH patients if the focus is treatment of risk factors.

• #27 Endoscopic third ventriculostomy for adults with hydrocephalus: creating a prognostic model for success: protocol for a retrospective multicentre study (Nordic ETV) | BMJ Open

  https://bmjopen.bmj.com/content/12/1/e055570

  Endoscopic third ventriculostomy (ETV) is becoming an increasingly widespread treatment for hydrocephalus, but research is primarily based on paediatric populations. […] The purpose of this study is to create a prognostic model to predict the success of ETV for adult patients with hydrocephalus. […] The ability to predict who will benefit from an ETV will allow better primary patient selection both for ETV and shunting. […] A success score specific for adults could also be used as a communication tool to provide better information and guidance to patients. […] The study is approved by appropriate ethics or patient safety boards in all participating countries. […] A prognostic scoring system for adult ETV can be created based on patient demographics, symptomatology, aetiology, shunt history and radiological findings.

• #28 Thieme E-Journals – min – Minimally Invasive Neurosurgery / Abstract

  https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-2006-950382

  An important factor in making a recommendation for different treatment modalities in hydrocephalus patients (VP shunt versus endoscopic third ventriculostomy) is the definition of the underlying pathology which determines the prognosis/outcome of the surgical procedure. […] This standardised grading system predicts the outcome of 3rd VS and helps in decision making for 3rd VS versus VP shunting.

• #29 Endoscopic third ventriculostomy for adults with hydrocephalus: creating a prognostic model for success: protocol for a retrospective multicentre study (Nordic ETV) | BMJ Open

  https://bmjopen.bmj.com/content/12/1/e055570

  Endoscopic third ventriculostomy (ETV) is becoming an increasingly widespread treatment for hydrocephalus, but research is primarily based on paediatric populations. […] The purpose of this study is to create a prognostic model to predict the success of ETV for adult patients with hydrocephalus. […] The ability to predict who will benefit from an ETV will allow better primary patient selection both for ETV and shunting. […] A success score specific for adults could also be used as a communication tool to provide better information and guidance to patients. […] The study is approved by appropriate ethics or patient safety boards in all participating countries. […] A prognostic scoring system for adult ETV can be created based on patient demographics, symptomatology, aetiology, shunt history and radiological findings.

• #30 Endoscopic third ventriculostomy for adults with hydrocephalus: creating a prognostic model for success: protocol for a retrospective multicentre study (Nordic ETV) | BMJ Open

  https://bmjopen.bmj.com/content/12/1/e055570

  With ETV becoming an increasingly widespread treatment for adult hydrocephalus, there is a need for a new prognostic model specific for this patient population. […] The ability to predict who will benefit from an ETV will allow better primary patient selection both for ETV and shunting. […] Creating a prognostic model for adults based on a large population will improve the ability to predict the outcome of ETV and offer the appropriate treatment. […] The goal is to increase the benefit for patients and reduce the number of unnecessary procedures.

• #31 Thieme E-Journals – min – Minimally Invasive Neurosurgery / Abstract

  https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-2006-950382

  An important factor in making a recommendation for different treatment modalities in hydrocephalus patients (VP shunt versus endoscopic third ventriculostomy) is the definition of the underlying pathology which determines the prognosis/outcome of the surgical procedure. […] This standardised grading system predicts the outcome of 3rd VS and helps in decision making for 3rd VS versus VP shunting.

• #32 Improving Infant Hydrocephalus Outcomes in Uganda: A Longitudinal Prospective Study Protocol for Predicting Developmental Outcomes and Identifying Patients at Risk for Early Treatment Failure after ETV/CPC

  https://www.mdpi.com/2218-1989/12/1/78

  Infant hydrocephalus poses a severe global health burden; 80% of cases occur in the developing world where patients have limited access to neurosurgical care. […] Although treatment focuses on controlling ventricle size, this has little association with treatment failure or long-term outcome. […] Despite the known benefits of successful ETV/CPC treatment for infant hydrocephalus, treatment failure remains a significant problem for about one-third of cases, most of which occur within six months with little occurring thereafter. […] Therefore, diagnostics to detect early treatment failure, evaluate treatment response and likelihood of future failure, and stratify pre-treatment patients are urgent unmet medical needs for improving infant hydrocephalus outcomes. […] We will investigate associations of CBF and CMRO2 with long-term brain growth and neurodevelopmental outcomes, and also explore the utility of FDNIRS-DCS measures as new biomarkers to aid the prediction of treatment failure.

• #33 Improving Infant Hydrocephalus Outcomes in Uganda: A Longitudinal Prospective Study Protocol for Predicting Developmental Outcomes and Identifying Patients at Risk for Early Treatment Failure after ETV/CPC

  https://www.mdpi.com/2218-1989/12/1/78

  The end point for this study’s treatment failure assessment is six months post-surgery, as the majority (pooled success rate of 63%, range 54–72%) of ETV failures occur before that time point. […] Surgical failure is defined as the need for any subsequent surgical procedure, including ETV revision, insertion of VPS, or shunt revision for definitive CSF diversion, as well as death related to hydrocephalus management within the first six months. […] We expect Z-scores for brain volume to be positively correlated with changes in CMRO2. However, since growth rates change rapidly in the first few months of life, regression coefficients are suspected to differ between baseline to six-month, six- to 12-month, and 12- to 24-month periods. […] This study is unique due to its complexity, involving multiple imaging modalities and a diverse research and clinical team.

• #34

  https://journals.lww.com/neur/fulltext/2021/69002/applications_of_machine_learning_in_pediatric.21.aspx

  Fifteen studies that described the use of ML models in the diagnosis, treatment, and prognostication of pediatric hydrocephalus were identified. […] ML models were used in all aspects of HCP care and management, that is, diagnosis, evaluating the need for intervention, and for predicting the complications associated with CSF shunting procedures. […] Four studies evaluated the prognostic applications of ML in HCP. Here, ANN was the most commonly used algorithm. […] ANN (AUC = 0.71, specificity = 90%) outperformed the other models to predict CSF shunt failure in pediatric patients. […] ANN (AUC = 91.98%) superseded LR (AUC = 76.5%) in predicting shunt infection in children with ventriculoperitoneal shunt. […] Adaboost was the most accurate ML model (AUC = 75.42 8.41). […] ANN had the highest accuracy rate (93.797.6) for predicting a successful ETV outcome at 6 months.

• #35

  https://journals.lww.com/neur/fulltext/2021/69002/applications_of_machine_learning_in_pediatric.21.aspx

  Fifteen studies that described the use of ML models in the diagnosis, treatment, and prognostication of pediatric hydrocephalus were identified. […] ML models were used in all aspects of HCP care and management, that is, diagnosis, evaluating the need for intervention, and for predicting the complications associated with CSF shunting procedures. […] Four studies evaluated the prognostic applications of ML in HCP. Here, ANN was the most commonly used algorithm. […] ANN (AUC = 0.71, specificity = 90%) outperformed the other models to predict CSF shunt failure in pediatric patients. […] ANN (AUC = 91.98%) superseded LR (AUC = 76.5%) in predicting shunt infection in children with ventriculoperitoneal shunt. […] Adaboost was the most accurate ML model (AUC = 75.42 8.41). […] ANN had the highest accuracy rate (93.797.6) for predicting a successful ETV outcome at 6 months.

• #36

  https://journals.lww.com/neur/fulltext/2021/69002/applications_of_machine_learning_in_pediatric.21.aspx

  ML models can assess large quantities of clinical data and radiological images, determine complex relationships among these variables, and predict whether intervention is necessary at the current clinical stage. […] The rapid advancement of AI and ML in the medical field can lead to improved outcomes in not just hydrocephalus but neurosurgical care as a whole. […] This study attempts to outline and present the important achievements in this field and encourages clinicians to develop other similar models that can revolutionize the management of pediatric hydrocephalus.

• #37 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Hydrocephalus-Prognosis.aspx

  The mortality rate for hydrocephalus and associated therapy ranges from 0 to 3%. This rate is highly dependent on the duration of follow-up care. The shunt event-free survival is approximately 70% at 12 months and is nearly half that at 10 years, post-operatively. […] The triad of early detection, prompt treatment, and taking the necessary steps to avoid surgical site infections is the cornerstone to ensuring a great long-term outlook. It particularly helps in reducing the chances of developing clinically significant neurological damage. Failure to catch hydrocephalus on time and treat it accordingly may lead to long-term neurological deficits that require multidisciplinary medical teams to assist patients with developmental and lasting cognitive impairment. Neurological damage that may have occurred prior to treatment is unfortunately irreversible and can have a significant impact on functional social outcomes such as social integration, schooling, and marriage.

• #38 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Hydrocephalus-Prognosis.aspx

  The mortality rate for hydrocephalus and associated therapy ranges from 0 to 3%. This rate is highly dependent on the duration of follow-up care. The shunt event-free survival is approximately 70% at 12 months and is nearly half that at 10 years, post-operatively. […] The triad of early detection, prompt treatment, and taking the necessary steps to avoid surgical site infections is the cornerstone to ensuring a great long-term outlook. It particularly helps in reducing the chances of developing clinically significant neurological damage. Failure to catch hydrocephalus on time and treat it accordingly may lead to long-term neurological deficits that require multidisciplinary medical teams to assist patients with developmental and lasting cognitive impairment. Neurological damage that may have occurred prior to treatment is unfortunately irreversible and can have a significant impact on functional social outcomes such as social integration, schooling, and marriage.

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