Hydrocephalus in posterior fossa tumors in children. Are there factors that determine a need for permanent cerebrospinal fluid diversion?

• Published in: Child's nervous system Vol. 24; no. 12; pp. 1397 - 1403
• Main Authors: Santos de Oliveira, Ricardo, Barros Jucá, Carlos Eduardo, Valera, Elvis Terci, Machado, Hélio Rubens
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01-12-2008
• Subjects: Adolescent; Age Factors; Brain Neoplasms - complications; Brain Neoplasms - pathology; Brain Neoplasms - surgery; Brazil; Cerebrospinal Fluid Shunts - methods; Child; Child, Preschool; Female; Humans; Hydrocephalus - etiology; Hydrocephalus - pathology; Hydrocephalus - surgery; Infant; Infratentorial Neoplasms - complications; Infratentorial Neoplasms - pathology; Infratentorial Neoplasms - surgery; Male; Medicine; Medicine & Public Health; Neurosciences; Neurosurgery; Original Paper; Postoperative Complications - etiology; Postoperative Complications - pathology; Postoperative Complications - surgery; Retrospective Studies; Risk Factors; Severity of Illness Index; Ventriculostomy - methods; Brazil; Endoscopic third ventriculostomy; Cerebrospinal fluid shunts; Hydrocephalus; Posterior fossa tumor; Pediatric neurosurgery
• ISSN: 0256-7040; 1433-0350
• DOI: 10.1007/s00381-008-0649-x

Objective
We searched for factors that could predispose towards persistent hydrocephalus in children with posterior fossa (PF) tumors in order to determine the need for permanent cerebrospinal fluid (CSF) diversion.
Methods
The clinical records of 64 children who underwent surgery for PF tumors in the Pediatric Neurosurgery division of the Hospital of Clinics, Ribeirao Preto, Brazil, from 1990 to 2006, were retrospectively reviewed. The patients’ ages ranged from 3 months to 18 years. The factors evaluated included age at surgery, severity of hydrocephalus (ventricular index), tumor location, size of the tumor, extent of tumor resection, and histology.
Results
Ventricular index, measured from the initial neuroradiological image, age at surgery, and location of the tumor were significantly associated with definitive postoperative CSF diversion (shunt or endoscopic third ventriculostomy), which was necessary for 34% of the patients.
Conclusions
Young children with severe preoperative hydrocephalus and a midline tumor should be considered at risk when preoperative treatment decisions are made.