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Hydrocephalus pp 306-310 | Cite as

Management of Hydrocephalus Secondary to Posterior Fossa Tumor in Childhood

  • Tadanori Tomita
  • Szymon S. Rosenblatt

Summary

A series of 112 children with cerebellum — fourth ventricle tumors treated surgically from 1980 through 1989 is presented. Pathology of these tumors consists of 52 medulloblastomas, 46 astrocytomas, and 14 ependymomas. All patients had a radical tumor resection, and patients with insufficient tumor resection or with other tumor histology are not included in this study. Neuroimaging studies showed hydrocephalus in all but 10 patients. For the management of associated hydrocephalus, a precraniotomy shunt was placed in 38 patients; 5 of them were complicated by upward herniation or intratumoral hemorrhage. After radical resection of the tumor, the precraniotomy shunt was successfully removed in 14 patients (36.8%). The remaining patients had posterior fossa craniotomy without shunt: 46 had intraoperative ventriculostomy and postoperative external ventricular drainage (EVD) and intracranial pressure (ICP) monitoring, while 20 had no postoperative EVD. Of 66 patients without precraniotomy shunts, 13 (20%) needed a permanent shunt after tumor resection. Hydrocephalus associated with a resectable posterior fossa tumor is best managed by intraoperative ventriculostomy and postoperative EVD and ICP monitoring, which provide a smooth postoperative course and avoid multiple surgical procedures and shunt-dependency.

Keywords

Hydrocephalus CSF shunt Cerebellar neoplasms Intracranial pressure monitor Upward herniation 

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References

  1. Ferrante L, Mastronardi L, Acqui M, Fortuna A (1990) Mutism after posterior fossa surgery in children. Report of three cases. J Neurosurg 72: 959–963Google Scholar
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Copyright information

© Springer-Verlag Tokyo 1991

Authors and Affiliations

  • Tadanori Tomita
  • Szymon S. Rosenblatt
    • 1
  1. 1.Division of Pediatric NeurosurgeryChildren’s Memorial Hospital and Northwestern University Medical SchoolChicagoUSA

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