title: Pediatric hydrocephalus: Does the shunt device pressure selection affect the outcome?
abstract: OBJECTIVE
  To compare the efficacy of low- versus medium-pressure shunts in pediatric hydrocephalus in a randomized controlled trial.
  
  
  METHODS
  Forty patients of pediatric hydrocephalus were randomized into two groups. The Chhabra differential pressure VP shunt (low or medium) was inserted in every patient. Postoperative follow-up was performed for symptomatic improvement and radiological evaluation (by sonography or computed tomography scan) for ventricle hemispheric ratio (VHR). Comparative analysis of pre- and postoperative VHR and need of redo surgery for shunt malformation were carried out to establish outcomes.
  
  
  RESULTS
  Nineteen patients had a low-pressure and 21 patients had a medium-pressure shunt inserted. The age of the patients ranged from 1 day to 10 years. The average preoperative VHR in group A was 55.37%, which reduced to 40% postoperatively (P = 0.00005); likewise, the pre- and postoperative VHR in group B were 61.57% and 42%, respectively, which was statistically significant (P = 0.0006). The complications of shunts and incidence of redo shunt surgery in both groups were not found to be statistically significant (P = 0.5614).
  
  
  CONCLUSIONS
  The study found no significant difference in the outcome of patients with low- or medium-pressure shunt placement in pediatric hydrocephalus.
authors.affiliation: Department of Pediatric Surgery, Himalayan Institute of Medical Sciences, Swami Ram Nagar, Dehra Dun, India.
authors.forename: Arvind
authors.initials: A
authors.lastname: Sinha
authors.forename: Anuj
authors.initials: A
authors.lastname: Sharma
authors.forename: Charitesh
authors.initials: C
authors.lastname: Gupta