• Shlomi Constantini, Spyros Sgouros, and Abhaya Kulkarni.
• Department of Pediatric Neurosurgery, Dana Children's Hospital, Tel Aviv Medical Center, Tel Aviv, Israel. sconsts@netvision.net.il
• World Neurosurg. 2013 Feb 1;79(2 Suppl):S23.e1-11.

ObjectivesThe aim of this report is to review current data on the role of neuroendoscopy in infants. Specific emphasis will be given to the International Infant Hydrocephalus Study (IIHS). Previous studies, available information, and future directions are discussed.MethodsThe IIHS is a major international endeavor comparing the results of endoscopic third ventriculostomy (ETV) to ventriculoperitoneal shunting in infants younger than 2 years of age. It is a prospective, randomized study, with a "parental preference" option, that recruits infants with aqueductal stenosis without a history of prematurity or other associated brain anomalies. The primary outcome measure is neurocognitive outcome at 5 years of age. In addition to IIHS data, we also looked at results of neuroendoscopy in infants with other indications, such as fourth ventricular outlet obstruction, Dandy Walker syndrome, etc.ResultsThe IIHS study includes more than 40 centers on all continents. To date, we have recruited more than 150 infants to the study. At this point we can only release limited data, namely that the complication rates are similar between the two arms. More patients are needed to finalize the study, with an endpoint of 250 children.ConclusionsNeuroendoscopy in infants can be performed with reasonable morbidity. The preferred indications in infants are still not totally refined, especially vis-a-vis shunting procedures. More international, multicenter efforts are required to clarify these points.Copyright © 2013 Elsevier Inc. All rights reserved.

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