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Hydrocephalus with brain tumors in children

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Abstract

Background

Tumor-associated hydrocephalus is common in primary pediatric brain tumors. The managements involve radical tumor resection, temporary external ventricular drainage, and different definite shunting procedures. The purpose of this study is to sum up our experience of definite shunting procedures for tumoral hydrocephalus in children and correlate with reported literatures.

Methods

This is a retrospective review of a series of 1,250 cases of primary pediatric brain tumors in patients <18 years of age collected in Taipei Veterans General Hospital from 1971 to 2008. Cases with questionable records about hydrocephalus were excluded.

Results

A total of 56.7% of cases presented hydrocephalus, including hydrocephalus that occurred at tumor diagnosis (51.5%), and hydrocephalus developed after tumor diagnosis (5.1%). At tumor diagnosis, the hydrocephalus was mainly obstructive type (98%) and rarely communicating type (1.9%). Definite shunting procedures in this series comprised of ventriculoperitoneal (VP) shunt in 54.4%, endoscopic third ventriculostomy (ETV) in 10.9%, subduroperitoneal (SP) shunt in 4.8%, septostomy in 0.7%, lumboperitoneal shunt in 0.6%, and ventriculoatrial shunt in 0.1% of patients with hydrocephalus. There was a tendency of decreasing requirement and changing timing for VP shunt implantation. There was a gradual increase in usage of ETV for hydrocephalus in specific types and locations of tumors.

Conclusion

In the past two decades, we tended to use the VP shunt more cautiously for obstructive tumoral hydrocephalus. We try to perform initial radical resection of tumors as indicated and the more frequent use of ETV in selective cases that help to decrease the requirement of VP shunt implantation.

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Acknowledgments

This clinical research work is supported by grant DOH99-TD-C-111-007 and the Pediatric Neuroscience Research Plan from Taipei Veterans General Hospital, Taipei, Taiwan.

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Authors and Affiliations

  1. Division of Pediatric Neurosurgery, Department of Neurosurgery, Neurological Institute, Veterans General Hospital, Taipei, VACRS, No. 210, Sec 2, Shih-Pai, Taipei, Taiwan, Republic of China, 11217

    Tai-Tong Wong, Muh-Lii Liang & Hsin-Hung Chen

  2. Department of Radiology, Taipei Veterans General Hospital and National Yang Ming University, School of Medicine, Taipei, Taiwan, Republic of China

    Feng-Chi Chang

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  1. Tai-Tong Wong
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Correspondence to Tai-Tong Wong.

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Wong, TT., Liang, ML., Chen, HH. et al. Hydrocephalus with brain tumors in children. Childs Nerv Syst 27, 1723–1734 (2011). https://doi.org/10.1007/s00381-011-1523-9

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  • DOI: https://doi.org/10.1007/s00381-011-1523-9

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