title: Palliative ventriculoperitoneal shunt in a pediatric patient with recurrent metastatic medulloblastoma.
abstract: The authors present a case report of a pediatric patient with recurrent metastatic medulloblastoma who demonstrated significant clinical improvement after placement of a palliative ventriculoperitoneal (VP) shunt. They also review the medical literature that supports palliative surgical management of hydrocephalus and intracranial hypertension (ICH) caused by leptomeningeal (LM) spread of malignancy. The burdens and benefits of an invasive surgical procedure must always be weighed carefully, especially at end-of-life. Yet for some patients with LM spread and ICH, VP shunting may improve their quality of life, although their prognosis remains poor.
authors.affiliation: Department of Hematology/Oncology, Rady Children's Hospital-San Diego, San Diego, California 92123, USA. dschiff@chsd.org
authors.forename: Deborah
authors.initials: D
authors.lastname: Schiff
authors.forename: Cassie
authors.initials: C
authors.lastname: Kline
authors.forename: Hal
authors.initials: H
authors.lastname: Meltzer
authors.forename: JoAnne
authors.initials: J
authors.lastname: Auger