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The effect of tumor removal via craniotomies on preoperative hydrocephalus in adult patients with intracranial tumors

  • Sayied Abdol Mohieb HosaineyEmail author
  • Benjamin Lassen
  • John K. Hald
  • Eirik Helseth
  • Torstein R. Meling
Original Article
  • 86 Downloads

Abstract

The efficacy of tumor removal via craniotomies on preoperative hydrocephalus (HC) in adult patients with intracranial tumors is largely unknown. Therefore, we sought to evaluate the effect of tumor resection in patients with preoperative HC and identify the incidence and risk factors for postoperative VP shunt dependency. All craniotomies for intracranial tumors at Oslo University Hospital in patients ≥ 18 years old during a 10-year period (2004–2013) were reviewed. Patients with radiologically confirmed HC requiring surgery and subsequent development of shunt dependency were identified by cross-linking our prospectively collected tumor database to surgical procedure codes for hydrocephalus treatment (AAF). Patients with preexisting ventriculoperitoneal (VP) shunts (N = 41) were excluded. From 4774 craniotomies performed on 4204 patients, a total of 373 patients (7.8%) with HC preoperatively were identified. Median age was 54.4 years (range 18.1–83.9 years). None were lost to follow-up. Of these, 10.5% (39/373) required permanent CSF shunting due to persisting postoperative HC. The risk of becoming VP shunt dependent in patients with preexisting HC was 7.0% (26/373) within 30 days and 8.9% (33/373) within 90 days. Only secondary (repeat) surgery was a significant risk factor for VP shunt dependency. In this large, contemporary, single-institution consecutive series, 10.5% of intracranial tumor patients with preoperative HC became shunt-dependent post-craniotomy, yielding a surgical cure rate for HC of 89.5%. To the best of our knowledge, this is the first and largest study regarding postoperative shunt dependency after craniotomies for intracranial tumors, and can serve as benchmark for future studies.

Keywords

Brain tumor Craniotomy Complications Preoperative hydrocephalus Postoperative hydrocephalus Ventriculoperitoneal shunt 

Notes

Funding

There are no financial disclosures or financial interests for the work reported in this manuscript.

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

The study has been approved by the institutional ethics committee (Personvernombudets tilrådning 2013/14574).

Informed consent

Informed consent was waived in accordance with the institutional regulations of the institutional ethics committee.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Neurosurgery, Southmead HospitalBristolUK
  2. 2.Faculty of Medicine, Institute of Clinical MedicineUniversity of OsloOsloNorway
  3. 3.Department of RadiologyHospital of Southern NorwayKristiansandNorway
  4. 4.Department of Radiology and Nuclear MedicineOslo University HospitalOsloNorway
  5. 5.Department of NeurosurgeryOslo University HospitalOsloNorway

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