title: Clinical characteristics and neuroimaging findings in 12 cases of recurrent glioblastoma with communicating hydrocephalus.
abstract: Clinically, recurrent glioblastoma multiforme (GBM) is often associated with communicating hydrocephalus. We hypothesized that there are specific magnetic resonance (MR) imaging findings at the diagnosis of recurrent GBM that predict subsequent hydrocephalus. Various clinical characteristics were investigated including outcome and MR imaging findings in 12 patients with recurrent GBM followed by hydrocephalus (Hydro group) and 21 patients with recurrent GBM without hydrocephalus (Non-hydro group). Patient age and presence of communicating hydrocephalus were significantly associated with poor outcome. Median survival with recurrent GBM was longer in the Non-hydro group than in the Hydro group. Low Karnofsky performance status (KPS) and poor recursive partitioning analysis (RPA) class (RPA class 3, 5, 6, or 7) at the diagnosis of recurrent GBM were associated with the presence of hydrocephalus. The incidence of leptomeningeal dissemination after recurrent GBM was higher in the Hydro group than in the Non-hydro group. Evans index and fractional anisotropy value showed no difference at the diagnosis of recurrent GBM, but some MR imaging findings indicated that lesion attached to the basal cistern and/or ventricle was closely associated with subsequent hydrocephalus. We recommend careful monitoring of the ventricle size and leptomeningeal dissemination, especially in patients with low KPS and/or poor RPA class, if MR imaging indicates that the lesion is attached to the basal cistern and/or ventricle at recurrence of GBM.
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
authors.forename: Kuniyuki
authors.initials: K
authors.lastname: Onuma
authors.forename: Eiichi
authors.initials: E
authors.lastname: Ishikawa
authors.forename: Masahide
authors.initials: M
authors.lastname: Matsuda
authors.forename: Koji
authors.initials: K
authors.lastname: Hirata
authors.forename: Satoru
authors.initials: S
authors.lastname: Osuka
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Masumoto
authors.forename: Alexander
authors.initials: A
authors.lastname: Zaboronok
authors.forename: Akira
authors.initials: A
authors.lastname: Matsumura
mesh_terms: D001932:Brain Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D002552:Cerebral Ventricles / Q000473:pathology; D003131:Combined Modality Therapy; D018450:Disease Progression; D017352:Echo-Planar Imaging; D005260:Female; D005909:Glioblastoma / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D006801:Humans; D006849:Hydrocephalus / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D007089:Image Enhancement; D007090:Image Interpretation, Computer-Assisted; D053208:Kaplan-Meier Estimate; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate