The HCRN registry is a huge database collecting detailed information on children at the HCRN centers. The information is entered in real time as children are treated and continuously checked for accuracy. This makes it a very valuable resource. Dr Jay Riva-Cambrin is the lead investigator for this project and at the American Society of Pediatric Neurosurgeons in February he presented the first analysis of the data. Dr Riva-Cambrin and our Ph.D. biostatistician, Richard Holubkov, looked at the factors that predict shunt failure in 1036 children after the first shunt insertion. They found that children under 6 months of age and children who had their shunt inserted with an endoscope had a higher chance of shunt failure. In addition, children with a congenital heart problem were at increased risk. Even more interesting was the list of factors that did not alter the risk of failure. This included: the cause of hydrocephalus, the type of valve used (including programmable valves), the use of ultrasound or guidance during the surgery, and surgeon volume. These important findings are now being prepared for publication and they will help us advise families and guide our future research.