Hydrocephalus in Pediatric Patients with Posterior Fossa Tumours

Abstract

The management of hydrocephalus associated with posterior fossa tumours in children has always been problematic: whilst the majority of patients will not require permanent CSF diversion, those patients who do so appear to suffer a stormier postoperative course [15] and are subject to the well-recognized problems associated with these devices. Although in the past it was often appropriate to shunt all these patients preoperatively [2], technological advances in and changes in the availability of neuroimaging have allowed earlier diagnosis. Consequently, most paediatric neurosurgeons today use a combination of corticosteroids, early surgery and external ventricular drainage where necessary. In the literature, approximately one-third of patients overall will eventually require a shunt [15]. The factors associated with shunt placement have been retrospectively analysed [6, 15] and include young age (<10 years), midline tumours, incomplete tumour resection, CSF infection and persistent pseudomeningocele.