Leonard H. Verhey, MD, PhD
2022 Resident’s Prize in Hydrocephalus
PROJECT TITLE: Re-evaluation of ETV Success Score in Children with Hydrocephalus: Multicentered Cohort Study of Clinical Research Network
Leonard H. Verhey, MD,PhD, completed a project for which he received the Annual HA Award at the AANS/CNS Peds Section Meeting in Washington DC. The project focused on knowing that the applicability or validity of the original ETV success score (developed by Dr. Kulkarni in 2009 using a retrospective cohort) has at times been questioned in current modern practice, they endeavored to re-evaluate the ETVS success score (ETVSS) using a modern prospective multinational cohort of the HCRN.
For the first objective, they identified preoperative clinical and radiographic variables associated with ETV success and built multivariable regression models to evaluate the extent to which these predicted ETV success at 6 months. Ultimately, age and etiology remain the most important predictors of ETV success; however, the new categorizations of age and etiology that we devised did not enhance predictive power beyond that of the original ETVSS. Therefore, no statistical or clinical reason to devise a new or revised ETVSS was found.
For their second objective, areas were explored for weakness in the current ETVSS, and found that for patients >= 12 months of age, current ETV success is greater than that predicted by the ETVSS for middle ranges success categories. Lastly, their objective was to evaluate radiographic variables predictive of ETV success; and detected a linear trend for prepontine adhesions, in that, as the degree of subarachnoid scarring on preoperative MRI increased, the likelihood for ETV success decreased. This finding warrants further investigation and replication in future studies.