The Endoscopic Third Ventriculostomy Success Score (ETVSS) is a predictive tool used by neurosurgeons and healthcare professionals to estimate the success rate of an Endoscopic Third Ventriculostomy (ETV) procedure. 

What Factors into the ETVSS?

The ETVSS considers three key factors:

Age: The patient’s age at the time of surgery, which influences the likelihood of ETV success.

Etiology: The underlying cause of hydrocephalus. Certain etiologies may respond better to ETV than others.

Previous Shunt: The presence or absence of a prior shunt procedure, with non-shunted patients typically having better outcomes.

How Is the ETVSS Calculated?

The ETVSS is the sum of points assigned to each factor:

Age:

Less than 1 month: 0 points

1 to 6 months: 10 points

6 months to 1 year: 30 points

1 to 10 years: 40 points

Older than 10 years: 50 points

Etiology:

Post-infectious: 0 points

Myelomeningocele, intraventricular hemorrhage, non-tectal brain tumor: 20 points

Aqueductal stenosis, tectal tumor, other etiologies: 30 points

Previous Shunt:

With previous shunt: 0 points

Without previous shunt: 10 points

Interpreting the ETVSS

The total score correlates with the percentage probability of ETV success, guiding clinicians in decision-making for hydrocephalus treatment. A higher score indicates a greater probability of success. For instance, a score closer to 0 suggests a lower chance of ETV being beneficial, while a score closer to 90 indicates a high likelihood of a successful outcome.

Why Use the ETVSS?

ETVSS serves as a crucial decision-making aid, providing an evidence-based approach to assessing the potential effectiveness of ETV in hydrocephalus management. It assists in evaluating whether ETV is a suitable alternative to shunt placement, which can be associated with various complications and a need for multiple revisions over time.

Incorporating the ETVSS into clinical practice allows for personalized patient care, optimizing treatment plans based on individual risk profiles and improving the overall management of hydrocephalus.