A 3-month-old infant is diagnosed with obstructive hydrocephalus due to aqueductal stenosis. What is the preferred definitive treatment?
- A Endoscopic third ventriculostomy ✓
- B Ventriculoperitoneal shunt
- C Serial lumbar punctures
- D Acetazolamide and furosemide
Correct answer: A. Endoscopic third ventriculostomy
Explanation
Endoscopic third ventriculostomy is the preferred treatment for obstructive hydrocephalus due to aqueductal stenosis, as it creates a bypass for CSF flow without requiring a permanent shunt. VP shunt is an alternative if ETV fails or is not feasible. Serial lumbar punctures are not effective for obstructive hydrocephalus. Acetazolamide may temporarily reduce CSF production but is not definitive treatment.
Reference: Nelson Textbook of Pediatrics, 21st ed.
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