Advertisement

Hydrocephalus in Pediatric Patients with Posterior Fossa Tumours

  • Christian Sainte-Rose
Chapter

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.

Keywords

Posterior Fossa Intracranial Hypertension Tumour Removal External Ventricular Drainage Posterior Fossa Tumour 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Abraham J, Chandy J: Ventriculo-atrial shunt in the management of posterior fossa tumours. Preliminary report. J Neurosurg 20:252–253, 1963PubMedCrossRefGoogle Scholar
  2. 2.
    Albright L, Reigel DH: Management of hydrocephalus secondary to posterior fossa tumours. J Neurosurg 46:52–55, 1977PubMedCrossRefGoogle Scholar
  3. 3.
    Allen JC, Epstein F: Medulloblastoma and other primary malignant neuroectodermal tumours of the CNS. The effects of patients’ age and extent of disease on prognosis. J Neurosurg 57:446–451, 1982PubMedCrossRefGoogle Scholar
  4. 4.
    Cinalli G, Salazar C, Yada JZ, et al: The role of third ventriculostomy in the management of shunt malfunction. Neurosurgery 43:323–1329, 1998Google Scholar
  5. 5.
    Cinalli G, Sainte-Rose C, Chumas P, et al: Failure of third ventriculostomy in the treatment of aqueductal stenosis in children. Journal of Neurosurgery 90:448–454, 1999PubMedCrossRefGoogle Scholar
  6. 6.
    Culley DJ, Berger MS, Shaw D, et al: An analysis of factors determining the need for ventriculoperitoneal shunts after posterior fossa tumour surgery in children. Neurosurgery 34:402–408, 1994PubMedCrossRefGoogle Scholar
  7. 7.
    Dias MS, Albright AL: Management of hydrocephalus complicating childhood posterior fossa tumours. Pediatr Neurosci 15:283–290, 1989PubMedCrossRefGoogle Scholar
  8. 8.
    Epstein F, Murali R: Pediatric posterior fossa tumours: Hazards of the ‘preoperative’ shunt. Neurosurgery 3: 348–350, 1978PubMedCrossRefGoogle Scholar
  9. 9.
    Forrest DM, Cooper DG: Complications of ventriculoatrial shunts. A review of 455 cases. J Neurosurg 29:506–512, 1968CrossRefGoogle Scholar
  10. 10.
    Hekmatpanah J, Mullan S: Ventriculo-caval shunt in the management of posterior fossa tumours. J Neurosurg 26:609–613, 1967PubMedCrossRefGoogle Scholar
  11. 11.
    Hopf NJ, Grunert P, Fries G, et al: Endoscopic third ventriculostomy: outcome analysis of 100 consecutive procedures. Neurosurgery 44:795–806, 1999PubMedCrossRefGoogle Scholar
  12. 12.
    Jones RF, Stening WA, Brydon M: Endoscopic third ventriculostomy. Neurosurgery 26:86–92, 1990PubMedCrossRefGoogle Scholar
  13. 13.
    Kelly PJ, Goerss S, Kall BA, et al: Computed tomography-based stereotactic third ventriculostomy: Technical note. Neurosurgery 18:791–794, 1986PubMedCrossRefGoogle Scholar
  14. 14.
    Keucher TR, Mealy J: Long-term results after ventriculoatrial and ventriculoperitoneal shunting for infantile hydrocephalus. J Neurosurg 50:179–186, 1979PubMedCrossRefGoogle Scholar
  15. 15.
    Lee M, Wisoff JH, Abbott R, et al: Management of hydrocephalus in children with medulloblastoma: Prognostic factors for shunting. Pediatr Neurosurg 20:240–247, 1994PubMedCrossRefGoogle Scholar
  16. 16.
    McLaurin RL: Disadvantages of the preoperative shunt in posterior fossa tumours. Clin Neurosurg 30:286–294, 1983PubMedGoogle Scholar
  17. 17.
    Muszynski CA, Laurent JP, Cheek WR: Effects of ventricular drainage and dural closure on cerebrospinal fluid leaks after posterior fossa tumour surgery. Pediatr Neurosurg 21:227–231, 1994PubMedCrossRefGoogle Scholar
  18. 18.
    Papo I, Caruselli G, Luongo A: External ventricular drainage in the management of posterior fossa tumours in children and adolescents. Neurosurgery 10:13–15, 1982PubMedCrossRefGoogle Scholar
  19. 19.
    Raimondi AJ, Tomita T: Hydrocephalus and infratentorial tumours. J Neurosurg 55:174–182, 1981PubMedCrossRefGoogle Scholar
  20. 20.
    Rappaport ZH, Shalit MN: Perioperative external ventricular drainage in obstructive hydrocephalus secondary to infratentorial brain tumours. Acta Neurochir 96:118–121, 1989CrossRefGoogle Scholar
  21. 21.
    Sainte-Rose C: Third ventriculostomy. In: Manwaring KH, Crone K (eds) Neuroendoscopy, vol 1. New York, Mary Ann Liebert pp 47–62, 1992.Google Scholar
  22. 22.
    Schmid UD, Seiler RW: Management of obstructive hydrocephalus secondary to posterior fossa tumours by steroids and subcutaneous ventricular catheter reservoir. J Neurosurg 65:649–653, 1986PubMedCrossRefGoogle Scholar
  23. 23.
    Shalit MN, Ben Ari Y, Eynan N: The management of obstructive hydrocephalus by the use of external continous ventricular drainage. Acta Neurochir (Wien) 47:161–172, 1979CrossRefGoogle Scholar
  24. 24.
    Stein BM, Tenner MS, Fraser RA: Hydrocephalus following removal of cerebellar astrocytomas in children. J Neurosurg 36:763–768, 1972PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2005

Authors and Affiliations

  • Christian Sainte-Rose
    • 1
  1. 1.Department of Paediatric NeurosurgeryHôpital Necker-Enfants MaladesParisFrance

Personalised recommendations