# Neurocognitive outcomes and changes in brain and CSF volume after treatment of post-infectious hydrocephalus in Ugandan infants by shunting or ETV/CPC: a randomized prospective trial

> **NIH NIH R01** · YALE UNIVERSITY · 2024 · $492,174

## Abstract

The goals of this R01 Renewal are driven by the results of our successfully conducted randomized
controlled clinical trial comparing endoscopic third ventriculostomy combined with choroid plexus
cauterization (ETV/CPC) to shunt treatment for post-infectious hydrocephalus (PIH, the most common
hydrocephalus etiology in Uganda) in infants < 6 months of age (ClinicalTrials.gov NCT01936272,
R01HD085853, R21HD068213) at the CURE Children’s Hospital of Uganda (CCHU). The interim
outcomes of this study are becoming a landmark in children’s medicine, finding that: a) at up to 24
months, there was no significant difference between ETV/CPC and shunt in regard to failure rate,
developmental outcome, and brain growth; b) brain volume, not CSF volume, correlated strongly with
developmental outcome; c) successful treatment of the hydrocephalus led to improved brain growth in
the first year, which stagnated during the second year. Because almost all of the failures of endoscopic
treatment occurred early in the first year of life, we anticipate that the longer term outcomes of
hydrocephalus treatment may favor endoscopy if we follow these children through primary school age
from 5 to 10 years. Furthermore, our ability to perform much more detailed neurocognitive assessments
during this further followup will be much more accurate than during our pre-school assessments. Lastly,
we can gather all of our data and perform a much more definitive cost-effectiveness analysis if we can
follow this unique cohort for a full 10 years.
 We have engaged in substantial capacity building during the previous 5 years of support during this
clinical trial. We have developed a thriving research unit at the CURE Children’s Hospital of Uganda,
enabling high-quality research to be conducted in multiple other NIH funded studies unrelated to this
clinical trial (DP1HD086071, R01AI145057, and R01HD096693). Furthermore, since all hydrocephalus
treatment requires brain imaging, we have developed a thriving center for sustainable low-field MRI
engineering at the Mbarara University of Science and Technology.
 This present project seeks to follow this unique cohort to 10 years of age, seeking to definitively
establish whether endoscopic treatment is more sustainable for infants in the developing world, establish
low field MRI as a sustainable imaging technology, and establish the capacity of both the medical and
engineering sites in Uganda as independent research and technology development centers for Africa.

## Key facts

- **NIH application ID:** 10890005
- **Project number:** 5R01HD085853-11
- **Recipient organization:** YALE UNIVERSITY
- **Principal Investigator:** Abhaya V Kulkarni
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $492,174
- **Award type:** 5
- **Project period:** 2022-11-01 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10890005

## Citation

> US National Institutes of Health, RePORTER application 10890005, Neurocognitive outcomes and changes in brain and CSF volume after treatment of post-infectious hydrocephalus in Ugandan infants by shunting or ETV/CPC: a randomized prospective trial (5R01HD085853-11). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10890005. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*