Hydrocephalus Related to CNS Malignancies in Adults

  • Emilie Le RhunEmail author
  • Jörg-Christian Tonn
  • Michael Weller


Central nervous system tumors represent a main cause of hydrocephalus which, in the overall course of disease, can be observed in approximately 5–10% of patients with glioblastoma and 6–24% of patients with central nervous system metastases. The incidence may be higher, up to 23%, in the adult population with fossa posterior tumors. Obstructive hydrocephalus is related to a mechanical block of CSF flow, whereas communicative hydrocephalus is related to an imbalance between CSF production and outflow. Several options are available for the management of hydrocephalus, depending on its cause and on the neurological condition of the patient: direct surgical removal of the responsible lesion or endoscopic third ventriculostomy (ETV) for obstructive hydrocephalus, ventriculoperitoneal (VPS) or ventriculoatrial (VA) shunt for communicative hydrocephalus, and external ventricular drainage (EVD) as a transient emergency measure. Obstructive hydrocephalus may result in peracute potentially fatal deterioration and thus may require an emergency procedure after diagnosis. Symptomatic pharmacological treatments such as steroids or analgesics usually have limited efficacy in patients with hydrocephalus. Rapid clinical improvement with improvement of the quality of life and sometimes the possibility to administer further oncologic treatment can often be achieved after a timely CSF diversion.


Obstructive Communicative Cerebrospinal Leptomeningeal Metastases Pressure Ventriculostomy Ventriculoperitoneal Shunt Drain 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Emilie Le Rhun
    • 1
    • 2
    • 3
    • 4
    Email author
  • Jörg-Christian Tonn
    • 5
  • Michael Weller
    • 4
  1. 1.Neuro-Oncology Department of NeurosurgeryUniversity Hospital Lille, Salengro HospitalLilleFrance
  2. 2.Neurology Department of Medical OncologyOscar Lambret CenterLilleFrance
  3. 3.Inserm U-1192Villeneuve d’AscqFrance
  4. 4.Department of NeurologyUniversity Hospital and University of ZurichZurichSwitzerland
  5. 5.Department of NeurosurgeryUniversity Hospital Ludwig Maximilian University MunichMunichGermany

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