Hydrocephalus in posterior fossa tumors in children. Are there factors that determine a need for permanent cerebrospinal fluid diversion?
OBJECTIVE
We searched for factors that could predispose towards persistent hydrocephalus in children with posterior fossa (PF) tumors in order to determine the need for permanent cerebrospinal fluid (CSF) diversion.


METHODS
The clinical records of 64 children who underwent surgery for PF tumors in the Pediatric Neurosurgery division of the Hospital of Clinics, Ribeirao Preto, Brazil, from 1990 to 2006, were retrospectively reviewed. The patients' ages ranged from 3 months to 18 years. The factors evaluated included age at surgery, severity of hydrocephalus (ventricular index), tumor location, size of the tumor, extent of tumor resection, and histology.


RESULTS
Ventricular index, measured from the initial neuroradiological image, age at surgery, and location of the tumor were significantly associated with definitive postoperative CSF diversion (shunt or endoscopic third ventriculostomy), which was necessary for 34% of the patients.


CONCLUSIONS
Young children with severe preoperative hydrocephalus and a midline tumor should be considered at risk when preoperative treatment decisions are made.
Division of Pediatric Neurosurgery, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, 14049-900, Brazil. rsoliveira@hcrp.fmrp.usp.br
Ricardo
R
Santos de Oliveira
Carlos Eduardo
CE
Barros Jucá
Elvis Terci
ET
Valera
Hélio Rubens
HR
Machado
D000293:Adolescent; D000367:Age Factors; D001932:Brain Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery; D001938:Brazil; D002557:Cerebrospinal Fluid Shunts / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D007223:Infant; D015192:Infratentorial Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D014696:Ventriculostomy / Q000379:methods