Frequency and treatment of hydrocephalus prior to and after posterior fossa tumor surgery in adult patients
There is paucity of information about the frequency of hydrocephalus prior to and after posterior fossa tumor surgery in adult patients and about the best way it should be managed. The present study was conducted to determine the frequency of hydrocephalus prior to and after posterior fossa tumor surgery in adult patients as well as the value of an endoscopic third ventriculostomy (ETV) prior to posterior fossa tumor surgery with regard to the rate of perioperative complications and persistent hydrocephalus.
A single-institution retrospective chart review of all posterior fossa tumor surgeries of our department in a 10-year period (2005 to 2014) has been done.
Fifty-two of 243 adult patients with posterior fossa tumors presented with hydrocephalus at the time of admission prior to tumor surgery. 39/52 received early tumor surgery, 11/52 an ETV prior to tumor surgery and in 2/52 an external ventricular drainage (EVD) was inserted prior to tumor surgery. 3/52 patients required a permanent cerebrospinal fluid (CSF) diverting procedure for persistent hydrocephalus after tumor removal. One hundred ninety-one patients did not demonstrate a hydrocephalus before surgical treatment and four of them developed a post-resection hydrocephalus.
The frequency of hydrocephalus prior to posterior fossa tumor surgery in adult patients is 21.4% and therefore much lower than in respective reports of pediatric patients. The risk of persistent hydrocephalus and newly developed hydrocephalus after tumor surgery was very low, too (5.7 and 2.1%, respectively). An ETV is not justified in every adult patient prior to posterior fossa tumor surgery.
KeywordsPosterior fossa tumor Hydrocephalus Adult Brain tumor Endoscopic third ventriculostomy Tumor-related hydrocephalus Persistent hydrocephalus Frequency of hydrocephalus
No funding was received for this research.
Compliance with ethical standards
Conflicts of interest
Henry W. S. Schroeder is a consultant to Karl Storz GmbH & Co. KG, Tuttlingen, Germany.
All other authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (name of institute/committee) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.
- 3.Dewan MC, Lim J, Shannon CN, Wellons JC 3rd (2017) The durability of endoscopic third ventriculostomy and ventriculoperitoneal shunts in children with hydrocephalus following posterior fossa tumor resection: a systematic review and time-to-failure analysis. J Neurosurg Pediatr 19:578–584CrossRefPubMedGoogle Scholar
- 4.Di Rocco F, Juca CE, Zerah M, Sainte-Rose C (2013) Endoscopic third ventriculostomy and posterior fossa tumors. World Neurosurg 79(S18):e15–e19Google Scholar
- 14.Le Fournier L, Delion M, Esvan M, De Carli E, Chappe C, Mercier P, et al (2017) Management of hydrocephalus in pediatric metastatic tumors of the posterior fossa at presentation. Childs Nerv Syst 33(9):1473–1480Google Scholar
- 18.Marx S, A; Manwaring, J, El Refaee, E; Fleck, SK; Fritsch, M; Gaab, MR; Schroeder, HWS; Baldauf, J (2017) Endoscopic Third Ventriculostomy prior to posterior fossa tumor surgery in adult patients. J Neurol Surg A Cent Eur Neurosurg. https://doi.org/10.1055/s-0037-1608786