Article
Frequency and treatment of hydrocephalus prior to and after surgery for posterior fossa tumors in adult patients
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Authors
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Sascha Marx
- Klinik und Poliklinik für Neurochirurgie, Universitätsmedizin Greifswald, Greifswald, Deutschland
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Maresa Reinfelder
- Klinik und Poliklinik für Neurochirurgie, Universitätsmedizin Greifswald, Greifswald, Deutschland
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Henry W. S. Schroeder
- Klinik und Poliklinik für Neurochirurgie, Universitätsmedizin Greifswald, Greifswald, Deutschland
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Joerg Baldauf
- Klinik und Poliklinik für Neurochirurgie, Universitätsmedizin Greifswald, Greifswald, Deutschland
| Published: | June 9, 2017 |
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Outline
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Objective: Conclusive data about the incidence of hydrocephalus prior to surgery and the resolution of hydrocephalus after posterior fossa tumor removal in adult patients has not been mentioned in detail. Whether there is a need of managing hydrocephalus before tumor surgery or not is still a matter of debate.
Methods: The authors present a consecutive series of posterior fossa tumor surgeries in adult patients between 2005 and 2014 of a single neurosurgical department. Presence of hydrocephalus before and after surgery as well as its respective treatment was assessed.
Results: 254 adult patients harbouring vestibular schwannomas (32.7%), metastases (26.8%), meningiomas (19.3%) and other lesions (21.2%) were included in the study. 52 patients (20.5%) suffered from symptomatic hydrocephalus at the time of diagnosis (21f, 31m, mean age 57.4 years, range from 21 to 87 years). Treatment options for hydrocephalus was early tumor surgery in 82.7% (n=43; group 1), ETV prior to tumor surgery in 13.5% (n=7; group 2) and EVD prior to tumor surgery in 3.8% (n=2; group 3). After tumor removal, further CSF diverting procedures were necessary in 11.6% (n=5) of patients in group 1. Neither patients of group 2 nor 3 had to be treated again for ventricular enlargement. Mean follow-up of patients was 26 months (range from 1 to 113 months). Three of 254 patients (1.2%) developed a new hydrocephalus after tumor surgery while no hydrocephalus was present prior to tumor surgery in these patients.
Conclusion: The present study revealed a clinically relevant hydrocephalus related to posterior fossa tumors in adult patients in 20.5% at the time of diagnosis. The primary treatment remains tumor removal itself, but contains a risk of persisting hydrocephalus (11.6%) requiring further surgery.
