Pediatric posterior fossa tumors: hazards of the "preoperative" shunt.
Many neurosurgeons recommend a "preoperative" shunt for children with posterior fossa tumors. It has been reported that the definitive surgery is simplified and the postoperative course is more benign as a result of the cerebrospinal fluid diversion. The present report documents complications as a result of upward herniation and hemorrhage within the tumor after shunt placement. On the basis of this experience, we conclude that a shunt is potentially hazardous and should be restricted to that selected group of patients who are acutely ill from increased intracranial pressure that is refractory to temporizing pharmacological management.
D000293:Adolescent; D001254:Astrocytoma / Q000601:surgery*; D001932:Brain Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001933:Brain Stem / Q000601:surgery*; D002531:Cerebellum / Q000601:surgery*; D002543:Cerebral Hemorrhage / Q000150:complications; D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects*; D002648:Child; D005260:Female; D006547:Hernia / Q000150:complications; D006801:Humans; D007427:Intracranial Pressure; D008297:Male; D010529:Peritoneal Cavity; D013909:Thorax; D014057:Tomography, X-Ray Computed