Pediatric hydrocephalus outcomes: a review

Fluids and Barriers of the CNS

Volumn 9, Issue 1, 2012, Pages

  Vinchon, Matthieu ^a   Rekate, Harold ^b   Kulkarni, Abhaya V ^c  

^a LILLE UNIVERSITY HOSPITAL   (France)

^b Chiari Institute   (United States)

^c HOSPITAL FOR SICK CHILDREN   (Canada)

Author keywords

Child to adult transition; Mortality; Outcome; Pediatric hydrocephalus; Shunt infection; Shunt obstruction

Indexed keywords

ANASTOMOSIS; CHILDHOOD DISEASE; CHILDHOOD MORTALITY; EPILEPSY; EVENT FREE SURVIVAL; FOLLOW UP; HUMAN; HYDROCEPHALUS; INTEGRATION; META ANALYSIS; MORBIDITY; NUCLEAR MAGNETIC RESONANCE IMAGING; OUTCOME ASSESSMENT; PREVALENCE; PRIORITY JOURNAL; PROSPECTIVE STUDY; QUALITY OF LIFE; REVIEW; SHUNT INFECTION; SYSTEMATIC REVIEW; X RAY;

EID: 84867860693     PISSN: None     EISSN: 20458118     Source Type: Journal    
DOI: 10.1186/2045-8118-9-18     Document Type: Review

References (95)

1. Laurence KM, Coates S. The natural history of hydrocephalus. Detailed analysis of 182 unoperated cases. Arch Dis Child 1962, 37:345-362. 10.1136/adc.37.194.345, 2012878, 14462827.
2. Acakpo-Satchivi L, Shannon CN, Tubbs RS, Wellons JC, Blount JP, Iskandar BJ, Oakes WJ. Death in shunted hydrocephalic children: a follow-up study. Childs Nerv Syst 2008, 24:197-201. 10.1007/s00381-007-0408-4, 17594102.
3. Iskandar BJ, Tubbs S, Mapstone TB, Grabb PA, Bartolucci AA, Oakes WJ. Death in shunted hydrocephalic children in the 1990s. Pediatr Neurosurg 1998, 28:173-176. 10.1159/000028644, 9732242.
4. Vinchon M, Baroncini M, Delestret I. Adult outcome of pediatric hydrocephalus. Childs Nerv Syst 2012, [Epub ahead of print]..
5. Sgouros S, Malluci C, Walsh AR, Hockley AD. Long-term complications of hydrocephalus. Pediatr Neurosurg 1995, 23:127-132. 10.1159/000120949, 8751293.
6. Odio C, McCracken GH, Nelson JD. CSF shunt infections in pediatrics. A seven-year experience. Am J Dis Child 1984, 138:1103-1108.
7. Kulkarni AV, Drake JM, Lamberti-Pasculli M. Cerebrospinal fluid shunt infection: a prospective study of risk factors. J Neurosurg 2001, 94:195-201. 10.3171/jns.2001.94.2.0195, 11213954.
8. Piatt JH, Carlson CV. A search for determinants of cerebrospinal fluid shunt survival: retrospective analysis of a 14-year institutional experience. Pediatr Neurosurg 1993, 19:233-242. 10.1159/000120738, 8398847.
9. Vinchon M, Dhellemmes P. Cerebrospinal fluid shunt infection: risk factors and long-term follow-up. Childs Nerv Syst 2006, 22:692-697. 10.1007/s00381-005-0037-8, 16534646.
10. Mangram AJ, Horna IP, Silver LC, Jarvis WR, . Hospital Infection Control Practices Advisory Committee Guidelines for prevention of surgical infection. Infect Control Hosp Epidemiol 1999, 20:247-280. Hospital Infection Control Practices Advisory Committee.
11. Renier D, Lacombe J, Pierre-Kahn A, Sainte-Rose C, Hirsch JF. Factors causing acute shunt infection. Computer analysis of 1174 operations. J Neurosurg 1984, 61:1072-1078. 10.3171/jns.1984.61.6.1072, 6502235.
12. Smith ER, Butler WE, Barker FG. In-hospital mortality rates after ventriculoperitoneal shunt procedures in the United States, 1998 to 2000: relation to hospital and surgeon volume of care. J Neurosurg 2004, 100(Suppl 2):90-97.
13. Albright AL, Pollack IF, Adelson PD, Solot JJ. Outcome data and analysis in pediatric neurosurgery. Neurosurgery 1999, 45:101-106. 10.1097/00006123-199907000-00025, 10414572.
14. Baskin JJ, Manwaring KH, Rekate HL. Ventricular shunt removal: the ultimate treatment of the slit ventricle syndrome. J Neurosurg 1998, 88:478-484. 10.3171/jns.1998.88.3.0478, 9488301.
15. Cinalli G, Salazar C, Mallucci C, Yada JZ, Zerah M, Sainte-Rose C. The role of endoscopic third ventriculostomy in the management of shunt malfunction. Neurosurgery 1998, 43:1323-1327.
16. Longatti PL, Carteri A. Active singling out of shunt independence. Childs Nerv Syst 1994, 10:334-336. 10.1007/BF00335173, 7954503.
17. Lorber J, Pucholt V. When is a shunt no longer necessary? An investigation of 300 patients with hydrocephalus and myelomeningocele: 11-22 year follow up. Z Kinderchir 1981, 34:327-329.
18. Talamonti G, D'Aliberti G, Collice M. Myelomeningocele: long-term neurosurgical treatment and follow-up in 202 patients. J Neurosurg 2007, 107(Suppl 5):368-386.
19. Di Rocco C, Massimi L, Tamburrini G. Shunts vs endoscopic third ventriculostomy in infants: are there different types and/or rates of complications? A review. Childs Nerv Syst 2006, 22:1573-1589. 10.1007/s00381-006-0194-4, 17053941.
20. O'Brien DF, Javadpour M, Collins DR, Spennato P, Mallucci CL. Endoscopic third ventriculostomy: an outcome analysis of primary cases and procedures performed after ventriculoperitoneal shunt malfunction. J Neurosurg 2005, 103(5 Suppl):393-400.
21. Ogiwara H, Dipatri AJ, Alden TD, Bowman RM, Tomita T. Endoscopic third ventriculostomy for obstructive hydrocephalus in children younger than 6 months of age. Childs Nerv Syst 2010, 26:343-347. 10.1007/s00381-009-1019-z, 19915853.
22. Fukuhara T, Vorster SJ, Luciano MG. Risk factors for failure of endoscopic third ventriculostomy for obstructive hydrocephalus. Neurosurgery 2000, 46:1100-1111. 10.1097/00006123-200005000-00015, 10807242.
23. Naftel RP, Reed GT, Kulkarni AV, Wellons JC. Evaluating the Children's Hospital of Alabama endoscopic third ventriculostomy experience using the Endoscopic Third Ventriculostomy Success Score: an external validation study. J Neurosurg Pediatr 2011, 8:494-501. 10.3171/2011.8.PEDS1145, 22044376.
24. Kulkarni AV, Drake JM, Kestle JR, Mallucci CL, Sgouros S, Constantini S, . Canadian Pediatric Neurosurgery Study Group Endoscopic third ventriculostomy vs cerebrospinal fluid shunt in the treatment of hydrocephalus in children: a propensity score-adjusted analysis. Neurosurgery 2010, 67:588-593. 10.1227/01.NEU.0000373199.79462.21, 20647973, Canadian Pediatric Neurosurgery Study Group.
25. Byard RW. Mechanisms of sudden death and autopsy findings in patients with Arnold-Chiari malformation and ventriculoatrial catheters. Am J Forensic Med 1996, 17:260-263.
26. Paulsen AH, Lundar T, Lindegaard KF. Twenty-year outcome in young adults with childhood hydrocephalus: assessment of surgical outcome, work participation, and health-related quality of life. J Neurosurg Pediatr 2010, 6:527-535. 10.3171/2010.9.PEDS09548, 21121726.
27. Resch B, Gedermann A, Maurer U, Ritschl E, Müller W. Neurodevelopmental outcome of hydrocephalus following intra-/periventricular hemorrhage in preterm infants: short- and long-term results. Childs Nerv Syst 1996, 12:27-33. 10.1007/BF00573851, 8869171.
28. Jennett B, Snoek J, Bond MR, Brooks N. Disability after severe head injury: observations on the use of the Glasgow outcome scale. J Neurol Neurosurg Psychiat 1981, 44:285-293. 10.1136/jnnp.44.4.285, 490949, 6453957.
29. Kulkarni AV, Shams I. Quality of life in children with hydrocephalus: results from the Hospital for Sick Children, Toronto. J Neurosurg 2007, 107(Suppl 5):358-364.
30. Platenkamp M, Hanlo PW, Fischer K, Gooskens RH. Outcome in pediatric hydrocephalus: a comparison between previously used outcome measures and the hydrocephalus outcome questionnaire. J Neurosurg 2007, 107(1 Suppl):26-31.
31. Dalen K, Bruarøy S, Wentzel-Larsen T, Laegreid LM. Intelligence in children with hydrocephalus, aged 4-15 years: a population-based, controlled study. Neuropediatrics 2008, 39:146-150. 10.1055/s-0028-1085463, 18991193.
32. Dennis M, Fitz CR, Netley CT, Sugar J, Harwood-Nash DC, Hendrick EB, Hoffman HJ, Humphreys RP. The intelligence of hydrocephalic children. Arch Neurol 1981, 38:607-615. 10.1001/archneur.1981.00510100035004, 6975094.
33. Venkataramana NK, Mukundan CR. Evaluation of functional outcomes in congenital hydrocephalus. J Pediatr Neurosci 2011, 6:4-12. 10.4103/1817-1745.85703, 3173913, 21977080.
34. Adams-Chapman I, Hansen NI, Stoll BJ, Higgins R, . NICHD Research Network Neurodevelopmental outcome of extremely low birth weight infants with posthemorrhagic hydrocephalus requiring shunt insertion. Pediatrics 2008, 121:e1167-e1177. 10.1542/peds.2007-0423, 2803352, 18390958, NICHD Research Network.
35. Andersson S, Persson EK, Aring E, Lindquist B, Dutton GN, Hellström A. Vision in children with hydrocephalus. Dev Med Child Neurol 2006, 48:836-841. 10.1017/S0012162206001794, 16978464.
36. Hoppe-Hirsch E, Laroussinie F, Brunet L, Sainte-Rose C, Renier D, Cinalli G, Zerah M, Pierre-Kahn A. Late outcome of the surgical treatment of hydrocephalus. Child's Nerv Syst 1998, 14:97-99. 10.1007/s003810050186, 23038804.
37. Gupta N, Park J, Solomon C, Kranz DA, Wrensch M, Wu YW. Long-term outcomes in patients with treated childhood hydrocephalus. J Neurosurg 2007, 106(5 Suppl):334-339.
38. Proos LA, Dahl M, Ahlsten G, Tuvemo T, Gustafsson J. Increased perinatal intracranial pressure and prediction of early puberty in girls with myelomeningocele. Arch Dis Child 1996, 75:42-45. 10.1136/adc.75.1.42, 1511676, 8813869.
39. Bourgeois M, Sainte-Rose C, Cinalli G, Maixner W, Malucci C, Zerah M, Pierre-Kahn A, Renier D, Hoppe-Hirsch E, Aicardi J. Epilepsy in children with shunted hydrocephalus. J Neurosurg 1999, 90:274-281. 10.3171/jns.1999.90.2.0274, 9950498.
40. Rekate HL, Kranz D. Headaches in patients with shunts. Semin Pediatr Neurol 2009, 16:27-30. 10.1016/j.spen.2009.01.001, 19410154.
41. Lacy M, Pyykkonen BA, Hunter SJ, Do T, Oliveira M, Austria E, Mottlow D, Larson E, Frim D. Intellectual functioning in children with early shunted posthemorrhagic hydrocephalus. Pediatr Neurosurg 2008, 44:376-378. 10.1159/000149904, 18703883.
42. Oakes WJ. Long-tem outcome of hydrocephalus. Editorial J Neurosurg 2007, 106(Suppl 5):333.
43. Hanlo PW, Cinalli G, Vandertop WP, Faber JA, Bøgeskov L, Børgesen SE, Boschert J, Chumas P, Eder H, Pople IK, Serlo W, Vitzthum E. Treatment of hydrocephalus determined by the European Orbis Sigma Valve II survey: a multicenter prospective 5-year shunt survival study in children and adults in whom a flow-regulating shunt was used. J Neurosurg 2003, 99:52-57. 10.3171/jns.2003.99.1.0052, 12854744.
44. Persson EK, Hagberg G, Uvebrant P. Disabilities in children with hydrocephalus-a population-based study of children aged between four and twelve years. Neuropediatrics 2006, 37:330-336. 10.1055/s-2007-964868, 17357034.
45. Xenos C, Sgouros S, Natarajan K, Walsh AR, Hockley A. Influence of shunt type on ventricular volume changes in children with hydrocephalus. J Neurosurg 2003, 98:277-383. 10.3171/jns.2003.98.2.0277, 12593611.
46. Kestle J, Drake J, Milner R, Sainte-Rose C, Cinalli G, Boop F, Piatt J, Haines S, Schiff S, Cochrane D, Steinbok P, MacNeil N. Long-term follow-up data from the Shunt Design Trial. Pediatr Neurosurg 2000, 33:230-236. 10.1159/000055960, 11155058.
47. Lindquist B, Persson EK, Fernell E, Uvebrant P. Very long-term follow-up of cognitive function in adults treated in infancy for hydrocephalus. Childs Nerv Syst 2011, 27:597-601. 10.1007/s00381-010-1311-y, 20972682.
48. Kokkonen J, Serlo W, Saukkonen AL, Juolasmaa A. Long-term prognosis for children with shunted hydrocephalus. Childs Nerv Syst 1994, 10:384-387. 10.1007/BF00335127, 7842425.
49. Lumenta CB, Skotarczak U. Long-term follow-up in 233 patients with congenital hydrocephalus. Childs Nerv Syst 1995, 11:173-175. 10.1007/BF00570260, 7773979.
50. Chi JH, Fullerton HJ, Gupta N. Time trends and demographics of deaths from congenital hydrocephalus in children in the United States: National Center for Health Statistics data, 1979 to 1998. J Neurosurg 2005, 103(Suppl 2):113-118.
51. Sainte-Rose C, Hoffmann HJ, Hirsch JF. Shunt failure. Concepts Pediatr Neurosurg 1989, 9:7-20.
52. Choux M, Genitori L, Lang D, Lena G. Shunt implantation: reducing the incidence of shunt infection. J Neurosurg 1992, 77:875-880. 10.3171/jns.1992.77.6.0875, 1432129.
53. Cochrane DD, Kestle JRW. The influence of surgical operative experience on the duration of first ventriculoperitoneal shunt function and infection. Pediatr Neurosurg 2003, 38:295-301. 10.1159/000070413, 12759508.
54. Iannelli A, Rea G, Di Rocco C. CSF shunt removal in children with hydrocephalus. Acta Neurochir (Wien) 2005, 147:503-507.
55. Hemmer R, Böhm B. Once a shunt, always a shunt?. Dev Med Child Neurol 1976, 37(suppl):69-73.
56. Kao CL, Yang TF, Wong TT, Cheng LY, Huang SY, Chen HS, Kao CL, Chan RC. The outcome of shunted hydrocephalic children. Zhonghua Yi Xue Za Zhi (Taipei) 2001, 64:47-53.
57. Heinsbergen I, Rotteveel J, Roeleveld N, Grotenhuis A. Outcome in shunted hydrocephalic children. Eur J Paediatr Neurol 2002, 6:99-107. 10.1053/ejpn.2001.0555, 11995963.
58. Tuli S, Tuli J, Drake J, Spears J. Predictors of death in pediatric patients requiring cerebrospinal fluid shunts. J Neurosurg 2004, 100(Suppl 5):442-446.
59. Persson EK, Anderson S, Wiklund LM, Uvebrant P. Hydrocephalus in children born in 1999-2002: epidemiology, outcome and ophthalmological findings. Childs Nerv Syst 2007, 23:1111-1118. 10.1007/s00381-007-0324-7, 17429657.
60. Piatt JH, Carlson CV. Hydrocephalus and epilepsy: an actuarial analysis. Neurosurgery 1996, 39:722-728. 10.1097/00006123-199610000-00014, 8880764.
61. Casey AT, Kimmings EJ, Kleinlugtebeld AD, Taylor WA, Harkness WF, Hayward RD. The long-term outlook for hydrocephalus in childhood. A ten-year cohort study of 155 patients. Pediatr Neurosurg 1997, 7:63-70.
62. Tuli S, Drake J, Lawless J, Wigg M, Lamberti-Pasculli M. Risk factors for repeated cerebrospinal shunt failures in pediatric patients with hydrocephalus. J Neurosurg 2000, 92:31-38. 10.3171/jns.2000.92.1.0031, 10616079.
63. Bryant MJ, McEniery J, Walker DG, Campbell R, Lister B, Sargent P, Withers TK, Baker J, Guazzo E, Rossato R, Anderson D, Tomlinson F. Preliminary study of shunt related death in paediatric patients. J Clin Neurosci 2004, 11:614-615. 10.1016/j.jocn.2003.09.016, 15261232.
64. Koch-Wiewrodt D, Wagner W. Success and failure of endoscopic third ventriculostomy in young infants: are there different age distributions?. Childs Nerv Syst 2006, 22:1537-1541. 10.1007/s00381-006-0191-7, 16944172.
65. Appelgren T, Zetterstrand S, Elfversson J, Nilsson D. Long-term outcome after treatment of hydrocephalus in children. Pediatr Neurosurg 2010, 46:221-226. 10.1159/000319365, 21051921.
66. Boynton BR, Boynton CA, Merritt TA, Vaucher YE, James HE, Bejar RF. Ventriculoperitoneal shunts in low birth weight infants with intracranial hemorrhage: neurodevelopmental outcome. Neurosurgery 1986, 18:141-145. 10.1227/00006123-198602000-00004, 3960289.
67. James HE, Bejar R, Gluck L, Coen R, Merritt A, Mannino F, Bromberger P, Saunders B, Schneider H. Ventriculoperitoneal shunts in high risk newborns weighing under 2000 grams: a clinical report. Neurosurgery 1984, 15:198-202. 10.1227/00006123-198408000-00009, 6483138.
68. Vinchon M, Lapeyre F, Duquennoy C, Dhellemmes P. Early treatment of posthemorrhagic hydrocephalus in low-birth-weight infants with valveless ventriculoperitoneal shunts. Pediatr Neurosurg 2001, 35:299-304. 10.1159/000050441, 11786697.
69. Buxton N, Macarthur D, Mallucci C, Punt J, Vloeberghs M. Neuroendoscopy in the premature population. Childs Nerv Syst 1998, 14:649-652. 10.1007/s003810050291, 9840365.
70. Lazareff JA, Peacock W, Holly L, Ver Halen J, Wong A, Olmstead C. Multiple shunt failures: an analysis of relevant factors. Childs Nerv Syst 1998, 14:271-275. 10.1007/s003810050223, 9694339.
71. Schoenbaum SC, Gardner P, Shillito J. Infections of cerebrospinal fluid shunts: epidemiology, clinical manifestations, and therapy. J Infect Dis 1975, 131:543-552. 10.1093/infdis/131.5.543, 1127260.
72. Warf BC, Dagi AR, Kaaya BN, Schiff SJ. Five-year survival and outcome of treatment for postinfectious hydrocephalus in Ugandan infants. J Neurosurg Pediatr 2011, 8:502-508. 10.3171/2011.8.PEDS11221, 22044377.
73. Quigley MR, Reigel DH, Kortyna R. Cerebrospinal fluid shunt infections. Report of 41 cases and a critical review of the literature. Pediatr Neurosci 1989, 15:111-120. 10.1159/000120455, 2702346.
74. Vinchon M, Dhellemmes P. Hydrocephalus in Myelomeningocele: Shunts and Problems with Shunts. The spina bifida: management and outcome 2008, 215-224. Milan: Springer, Ozek M, Cinalli G, Maixner WJ.
75. Hader WJ, Walker RL, Myles ST, Hamilton M. Complications of endoscopic third ventriculostomy in previously shunted patients. Neurosurgery 2008, 63(1 Suppl 1):ONS168-ONS174.
76. Hetherington R, Dennis M, Barnes M, Drake J, Gentili F. Functional outcome in young adults with spina bifida and hydrocephalus. Childs Nerv Syst 2006, 22:117-124. 10.1007/s00381-005-1231-4, 16170574.
77. Hunt GM, Oakeshot P, Kerry S. Link between the CSF shunt and achievement in adults with spina bifida. J Neurol Neurosurg Psychiatr 1999, 67:591-595. 10.1136/jnnp.67.5.591, 1736621, 10519863.
78. Kulkarni AV, Drake JM, Rabin D, Dirks PB, Humphreys RP, Rutka JT. Measuring the health status of children with hydrocephalus by using a new outcome measure. J Neurosurg 2004, 101(Suppl 2):141-146.
79. Kulkarni AV, Hui S, Shams I, Donnelly R. Quality of life in obstructive hydrocephalus: endoscopic third ventriculostomy compared to cerebrospinal fluid shunt. Childs Nerv Syst 2010, 26:75-79. 10.1007/s00381-009-0983-7, 19714338.
80. Kramer U, Kanner AA, Siomin V, Harel S, Constantini S. No evidence of epilepsy following endoscopic third ventriculostomy: a short-term follow-up. Pediatr Neurosurg 2001, 34:121-123. 10.1159/000056006, 11359099.
81. Gathura E, Poenaru D, Bransford R, Albright AL. Outcomes of ventriculoperitoneal shunt insertion in Sub-Saharan Africa. J Neurosurg Pediatr 2010, 6:329-335. 10.3171/2010.7.PEDS09543, 20887104.
82. Vinchon M, Fichten A, Delestret I, Dhellemmes P. Shunt revision for asymptomatic failure: surgical and clinical results. Neurosurgery 2003, 52:347-353. 10.1227/01.NEU.0000043932.84900.70, 12535363.
83. O'Kane MC, Richards H, Winfield P, Pickard JD. The United Kingdom Shunt Registry. Eur J Pediatr Surg 1997, 7(Suppl 1):56.
84. Chern JJ, Macias CG, Jea A, Curry DJ, Luerssen TG, Whitehead WE. Effectiveness of a clinical pathway for patients with cerebrospinal fluid shunt malfunction. J Neurosurg Pediatr 2010, 6:318-324. 10.3171/2010.7.PEDS09534, 20887102.
85. Buxton N, Punt J. Failure to follow patients with hydrocephalus shunts can lead to death. Br J Neurosurg 1998, 12:399-401. 10.1080/02688699844574, 10070440.
86. Hockley AD, Walsh AR, Sgouros S. Follow-up of children with shunted hydrocephalus (letter). Br J Neurosurg 1996, 10:525.
87. Kimmings E, Kleinlugtebeld A, Casey AT, Hayward RD. Does the child with shunted hydrocephalus require long-term neurosurgical follow-up?. Br J Neurosurg 1996, 10:77-81. 10.1080/02688699650040557, 8672262.
88. Colak A, Albright AL, Pollack IF. Follow-up of children with shunted hydrocephalus. Pediatr Neurosurg 1997, 27:208-210. 10.1159/000121253, 9577975.
89. Tuli S, O'Hayon B, Drake J, Clarke M, Kestle J. Change in Ventricular Size and Effect of Ventricular Catheter Placement in Pediatric Patients with Shunted Hydrocephalus. Neurosurgery 1999, 45:1329-1335. 10.1097/00006123-199912000-00012, 10598700.
90. Steinbok P, Boyd M, Flodmark CO, Cochrane DD. Radiographic imaging requirements following ventriculoperitoneal shunt procedures. Pediatr Neurosurg 1995, 22:141-146. 10.1159/000120892, 7786807.
91. Iskandar BJ, Sansone JM, Medow J, Rowley HA. The use of quick-brain magnetic resonance imaging in the evaluation of shunt-treated hydrocephalus. J Neurosurg 2004, 101(Suppl 2):147-151.
92. Vassilyadi M, Tataryn ZL, Alkherayf F, Udjus K, Ventureyra EC. The necessity of shunt series. J Neurosurg Pediatr 2010, 6:468-473. 10.3171/2010.8.PEDS09557, 21039171.
93. Drake J, Chumas P, Kestle J, Pierre-Kahn A, Vinchon M, Brown J, Pollack IF, Arai H. Late rapid deterioration after endoscopic third ventriculostomy: additional cases and review of the literature. J Neurosurg 2006, 105(Suppl 2):118-126.
94. Mohanty A, Vasudev MK, Sampath S, Radhesh S, Sastry Kolluri VR. Failed endoscopic third ventriculostomy in children: management options. Pediatr Neurosurg 2002, 37:304-309. 10.1159/000066310, 12422045.
95. Vinchon M, Dhellemmes P. The transition from child to adult in neurosurgery. Adv Tech Stand Neurosurg 2007, 32:3-24. 10.1007/978-3-211-47423-5_1, 17907472.