Under what circumstances do you consider placement of a reservoir for infants with congenital hydrocephalus?
Only if the baby is premature or there is a contraindication to permanent diversion (hostile abdomen, systemic disease, infection of unknown etiology, etc.)
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My practice has always been to monitor both serial head circumference measurements, how far apart (split) the sutures are, and the fullness of the anterior fontanel, as well as any signs of elevated intracranial pressure such as bradycardia without another identifiable cause, and serial head ultraso...
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I would consider placement of a VAD or other temporizing method for any child with an increasing ventricular ratio and growth of their FOC beyond expected percentiles, if they are too small for a shunt or not an ETV candidate. This, of course, assumes that the child is still several weeks away from ...
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