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The two available treatments for infant hydrocephalus are ventriculoperitoneal shunting and endoscopic third ventriculostomy. The endoscopic procedure relieves hydrocephalus by diverting the flow of cerebrospinal fluid (CSF). Ventriculoperitoneal shunting is technically straightforward and has a lower rate of failure in the months immediately after surgery than does ETV, but it is more prone to failure over the long term. Patients with shunt-dependent hydrocephalus can require urgent shunt-revision surgery because of obstruction of the shunt tubing or valve. ETV is technically more difficult than shunting, but it has the advantage that virtually all failures occur within 6 months, after which the risk of failure is low. Ventricular shunting, however, also generally results in a greater reduction of ventricle size than does ETV, potentially leading to better cognitive outcome than the endoscopic procedure. Professor Abhaya Vivek Kulkarni is giving a lecture on "ETV versus shunt for infant hydrocephalus", don't miss it!