title: Factors predicting the development of new onset post-operative Hydrocephalus following trans-sphenoidal surgery for pituitary adenoma.
abstract: BACKGROUND
  The aim of this retrospective study was to identify the factors which can predict the development of new onset post-operative Hydrocephalus following transsphenoidal surgery for pituitary adenomas.
  
  
  METHODS
  A total of 224 patients with the diagnosis of pituitary adenoma and without preoperative Hydrocephalus were identified from 1995 to 2012. Age, gender, tumor volumes, prior craniotomy and irradiation, outcome, hospital stay, CSF leak, infection and functional status of the tumor were included in the model for analysis.
  
  
  RESULTS
  A total of 13 patients (5.8%) developed new onset post-operative Hydrocephalus. Intraoperative and post-operative CSF leaks were noted in 19 (8.5%) and 17 (7.6%) patients respectively. CSF infection was seen in only 7 (3.1%) patients. Age of the patient (p=0.010), length of hospital stay (p=0.012), intraoperative CSF leak (p=0.000), post-operative CSF leak (p=0.000) and CSF infection (p=0.000) had shown significant correlation with the de novo onset of postoperative HC. The independent predictors of post-operative HC were post-operative CSF leak [p=0.002, OR 27.898, 95% CI 3.350-232.311] and intra-operative CSF leak [p=0.050, OR 7.687, 95% CI 1.003-58.924].
  
  
  CONCLUSIONS
  Age of the patient, intra-operative and post-operative CSF leak, CSF infection and duration of hospital stay were correlated with the development of HC. Post-operative and intra-operative CSF leaks were the independent predictors of new onset HC.
authors.affiliation: Department of Neurosurgery, Louisiana State University Health Science Center, Shreveport 71105, USA.
authors.forename: Mayur
authors.initials: M
authors.lastname: Sharma
authors.forename: Sudheer
authors.initials: S
authors.lastname: Ambekar
authors.forename: Ashish
authors.initials: A
authors.lastname: Sonig
authors.forename: Anil
authors.initials: A
authors.lastname: Nanda
mesh_terms: D000236:Adenoma / Q000601:surgery*; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D065634:Cerebrospinal Fluid Leak; D002559:Cerebrospinal Fluid Rhinorrhea / Q000209:etiology; D005163:Factor Analysis, Statistical; D005260:Female; D023261:Glasgow Outcome Scale; D006801:Humans; D006849:Hydrocephalus / Q000453:epidemiology / Q000209:etiology*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D011379:Prognosis; D012044:Regression Analysis; D012189:Retrospective Studies; D013100:Sphenoid Bone / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: CSF; GOS; Glasgow outcome scale; HC; Hydrocephalus; ICP; MRI; Pituitary adenoma; Predictive factors; TSS; Transsphenoidal surgery; cerebrospinal fluid; intracranial pressure; magnetic resonance imaging; trans-sphenoidal surgery