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Endoscopic third ventriculostomy: the best option in the treatment of persistent hydrocephalus after posterior cranial fossa tumour removal?

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Abstract

Background

Ten to 40% of children operated on for a posterior fossa tumour require a further surgical procedure for the management of a persisting active ventricular dilation. The management of this kind of hydrocephalus is still controversial.

Objective

To prospectively evaluate the effectiveness of post-operative endoscopic third ventriculostomy (ETV) in the management of persistent active hydrocephalus in a series of children operated on for a posterior cranial fossa tumour.

Methods

The management protocol consisted of: (1) placement of a peri-operative antibiotic impregnated external ventricular catheter (Bactiseal®) and tumour removal, (2) post-operative intracranial pressure (ICP) monitoring through the external ventricular drainage, (3) ETV in case of persistent ventricular dilation and persistently abnormal high ICP values and (4) ventriculoperitoneal shunt implantation in case of ETV failure.

Results

Thirty on a total of 104 children (28.8%) operated on between January 2001 and February 2007 at our institution needed a further surgical treatment for the persistence of the hydrocephalus after the removal of their posterior cranial fossa tumour. They were sub-divided in two groups according to the early (group 1—21 patients) or later (group 2—nine patients) definition of the persistence of an active ventricular dilation based on clinical, radiological and ICP monitoring data. ETV was successful in 90.0% of the patients in the present series (27/30 patients), without statistically significant differences among the two groups considered.

Conclusions

Post-operative ETV should be considered the best option to treat persistent hydrocephalus after the removal of posterior fossa tumours.

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References

  1. Dias MS, Albright AL (1989) Management of hydrocephalus complicating childhood posterior fossa tumors. Pediatr Neurosci 15:283–290

    Article  PubMed  CAS  Google Scholar 

  2. Gnanalingham KK, Lafuente J, Thompson D, Harkness W, Hayward R (2003) The natural history of ventriculomegaly and tonsillar herniation in children with posterior fossa tumours—an MRI study. Pediatr Neurosurg 39:246–253

    Article  PubMed  Google Scholar 

  3. Chumas P, Sainte-Rose C, Cinalli G (1995) III ventriculostomy in the management of posterior fossa tumors in children. Child’s Nerv Syst 11:540 Santiago, Chile, 26–29 September 1995

    Google Scholar 

  4. Ruggiero C, Cinalli G, Spennato P, Aliberti F, Cianciulli E, Trischitta V, Maggi G (2004) Endoscopic third ventriculostomy in the treatment of hydrocephalus in posterior fossa tumors in children. Child’s Nerv Syst 20:828–833

    Article  Google Scholar 

  5. Sainte-Rose C, Cinalli G, Roux FE (2001) Management of hydrocephalus in pediatric patients with posterior fossa tumors: the role of endoscopic third ventriculostomy. J Neurosurg 95:791–797

    Article  PubMed  CAS  Google Scholar 

  6. Fritsch MJ, Doerner L, Kienke S, Mehdorn HM (2005) Hydrocephalus in children with posterior fossa tumors: role of endoscopic third ventriculostomy. J Neurosurg (Suppl) 103:40–42

    Google Scholar 

  7. Bognar L, Borgulya G, Benke P, Madarassy G (2003) Analysis of CSF shunting procedure requirement in children with posterior fossa tumors. Child’s Nerv Syst 19:332–336

    Article  Google Scholar 

  8. Taylor WAS, Todd NV, Leighton SEJ (1992) CSF drainage in patients with posterior fossa tumours. Acta Neurochir (Wien) 117:1–6

    Article  CAS  Google Scholar 

  9. Lee M, Wisoff JH, Abbott R (1994) Management of hydrocephalus in children with medulloblastoma: prognostic factors for shunting. Pediatr Neurosurg 20:240–247

    Article  PubMed  CAS  Google Scholar 

  10. Due-Tonnessen BJ, Helseth E (2007) Management of hydrocephalus in children with posterior fossa tumors: role of tumor surgery. Pediatr Neurosurg 43:92–96

    Article  PubMed  Google Scholar 

  11. Schijman E, Peter JC, Rekate HL, Sgouros S, Wong TT (2004) Management of hydrocephalus in posterior fossa tumors: how, what, when? Child’s Nerv Syst 20:192–194

    Article  Google Scholar 

  12. Tamburrini G, Di Rocco C, Caldarelli M, Di Rocco F, Sabatino G, Koutzoglou M (2003) Postoperative third ventriculostomy in children with posterior cranial fossa tumors. Child’s Nerv Syst 19:691–692

    Google Scholar 

  13. Santos de Oliveira R, Barros Jucà C, Valera ET, Machado HR (2008) Hydrocephalus in posterior fossa tumors in children. Are there factors that determine a need for permanent cerebrospinal fluid diversion? Child’s Nerv Syst doi:10.1007/s00381-008-0649-x

  14. Culley DJ, Berger MS, Shaw D (1994) An analysis of factors determining the need for ventriculoperitoneal shunts after posterior fossa tumor surgery in children. Neurosurgery 34:402–408

    Article  PubMed  CAS  Google Scholar 

  15. Papo I, Caruselli G, Luongo A (1982) External ventricular drainage in the management of posterior fossa tumors in children and adolescents. Neurosurgery 10:13–15

    Article  PubMed  CAS  Google Scholar 

  16. Di Rocco C, Massimi L, Tamburrini G (2006) Shunts vs endoscopic third ventriculostomy in infants: are there different types and\or rates of complications. Child’s Nerv Syst 22:1573–1589

    Article  Google Scholar 

  17. Jones RF, Stening WA, Brydon M (1990) Endoscopic third ventriculostomy. Neurosurgery 26:86–91

    Article  PubMed  CAS  Google Scholar 

  18. Morelli D, Pirotte B, Lubansu A, Detemmerman D, Aeby A, Fricx C, Berrè J, David P, Brotchi J (2005) Persistent hydrocephalus after early surgical management of posterior fossa tumors in children: is routine preoperative endoscopic third ventriculostomy justified? J Neurosurg (Suppl) 103:247–252

    Google Scholar 

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Acknowledgment

This study was supported by the Association “Ali di scorta”, www.alidiscorta.it.

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Authors and Affiliations

  1. Paediatric Neurosurgery, Institute of Neurosurgery, Catholic University Medical School, Rome, Italy

    G. Tamburrini, B. L. Pettorini, L. Massimi, M. Caldarelli & C. Di Rocco

  2. Paediatric Neurosurgery, Catholic University of Rome, Largo Agostino Gemelli, 8, 00168, Rome, Italy

    G. Tamburrini

Authors
  1. G. Tamburrini
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  2. B. L. Pettorini
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  3. L. Massimi
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  4. M. Caldarelli
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  5. C. Di Rocco
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Corresponding author

Correspondence to G. Tamburrini.

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Tamburrini, G., Pettorini, B.L., Massimi, L. et al. Endoscopic third ventriculostomy: the best option in the treatment of persistent hydrocephalus after posterior cranial fossa tumour removal?. Childs Nerv Syst 24, 1405–1412 (2008). https://doi.org/10.1007/s00381-008-0699-0

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  • DOI: https://doi.org/10.1007/s00381-008-0699-0

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