الفهرس 
Introduction & Aim of the WorkOnly 14 pages are availabe for public view
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Abstract
Introduction:Different surgical management of infants suffering neural tube defects (NTD) associated hydrocephalus was reported in the literature. Great debate whether combining endoscopic third ventriculostomy (ETV) with choroid plexus cauterization (CPC) is more effective than ventriculoperitoneal (VP) shunt for management of congenital hydrocephalus secondary to neural tube defects in infants younger than 1 year of age. Aim of work: To evaluate and compare the therapeutic efficacy of ETV combined with CPC versus VP shunts in infants with infantile hydrocephalus associated with NTD. Summary:Thirty infants with infantile NTD associated hydrocephalus (de novo), were equally divided and randomly allocated to each intervention group either ETV/CPC or VP shunt.They were monitored for a period ranged from 6 months up to 30 months with median follow up was 18 months for any sign of raised intracranial pressure (rICP) and/or hydrocephalic metrics (fontanelle quality, HC, and ventricular size) were also documented and compared between two groups. This was a prospective randomized controlled comparative study, carried on prospectively in the Neurosurgery Department, Mansoura University. The association between intervention group and outcome was tested with Chi-square test and P=0.05 or less was considered statistically significant. Of the total thirty patients included in the study, thirteen patients (43.3%) were male and seventeen were female (56.7%) with mean age of 3.2 month and median age was 1 months. Twenty patients (66%) were under 6 months of age. The overall success rate in 1-year follow-up was 53.3% and 60% for VP shunt and ETV/CPC, respectively; with the difference being not statistically significant. Recommendations • Combined ETV-CPC is considered a successful surgical option for treatment of infantile hydrocephalus associated with NTD; achieving success rate better than VPS implantation • ETV and CPC would be used as first line of treatment of hydrocephalus associated with NTD even in infants below 6 months of age. • We recommend shunts for patients with high risk of ETV/CPC failure (prepontine cistern scarring, difficult creating stoma at the floor of third ventricle).