Hydrocephalus surveillance following CSF diversion: a modified Delphi study.

Area of Science:

• Neurosurgery
• Pediatric Neurology
• Medical Imaging

Background:

• Long-term follow-up for hydrocephalus is recommended but lacks defined protocols for clinical visits, imaging, and surveillance duration.
• Current practices for monitoring patients post-surgical treatment for hydrocephalus are inconsistent.

Purpose of the Study:

• To achieve expert consensus on the optimal modality, frequency, and duration of hydrocephalus surveillance after surgical intervention.
• To establish standardized guidelines for postoperative follow-up in hydrocephalus management.

Main Methods:

• Modified Delphi method employed with pediatric neurosurgeons from the Hydrocephalus Clinical Research Network (HCRN).
• Anonymous electronic surveys with Likert scale responses followed by a virtual meeting for discussion and consensus building (≥80% agreement).

Main Results:

• Seventeen consensus statements were achieved on standardization, preferred imaging, and postoperative follow-up after shunt surgery and endoscopic third ventriculostomy.
• Consensus was reached regarding immediate and delayed postoperative imaging, clinical surveillance, and radiological surveillance.
• Consensus could not be achieved for 19 statements, indicating areas needing further research.

Conclusions:

• The modified Delphi method successfully generated 17 consensus statements for clinical and radiological follow-up post-hydrocephalus surgery.
• The study highlights existing gaps in data to guide clinical practice for hydrocephalus surveillance.
• A standardized framework for hydrocephalus surveillance is proposed to improve patient care and optimize healthcare resource utilization.