title: Hydrocephalus after resection and adjuvant radiochemotherapy in patients with glioblastoma.
abstract: OBJECTIVE
  Glioblastomas are the most common primary malignant brain tumors in adults with a poor prognosis. The current study sought to identify risk factors in glioblastoma patients that are closely associated with communicating hydrocephalus.
  
  
  METHODS
  We retrospectively analyzed data from 151 patients who were diagnosed with a glioblastoma between 2007 and 2011 and underwent complete surgical resection closely followed by adjuvant radiochemotherapy.
  
  
  RESULTS
  We observed a significant tendency toward communicating hydrocephalus in cases of ventricular opening during surgical tumor resection (Fisher's exact test p<0.001) and a noticeable, although not statistically significant, correlation between the onset of communicating hydrocephalus and evidence of leptomeningeal tumor dissemination (Fisher's exact test p=0.067). Additionally, there was a trend toward frontal tumor location and a larger tumor volume in patients with communicating hydrocephalus. The majority of patients suffering from communicating hydrocephalus received a cerebrospinal fluid (CSF) shunt implantation after radiation therapy (63.6%, Fisher's exact test p=0.000).
  
  
  CONCLUSIONS
  We identified the following risk factors associated with the onset of communicating hydrocephalus in glioblastoma patients: ventricular opening during tumor resection and leptomeningeal tumor dissemination. Shunt implantation seems to be safe and effective in these patients.
authors.affiliation: Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland. Electronic address: claudiamiranda.fischer@usz.ch.
authors.forename: Claudia M
authors.initials: CM
authors.lastname: Fischer
authors.affiliation: Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Marian C
authors.initials: MC
authors.lastname: Neidert
authors.affiliation: Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Dominik
authors.initials: D
authors.lastname: Péus
authors.affiliation: Department of Neuroradiology(,) University Hospital Zurich, Zurich, Switzerland.
authors.forename: Nils H
authors.initials: NH
authors.lastname: Ulrich
authors.affiliation: Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Luca
authors.initials: L
authors.lastname: Regli
authors.affiliation: Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Niklaus
authors.initials: N
authors.lastname: Krayenbühl
authors.affiliation: Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Christoph M
authors.initials: CM
authors.lastname: Woernle
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D002552:Cerebral Ventricles / Q000601:surgery*; D059186:Chemoradiotherapy, Adjuvant; D003399:Craniotomy; D005260:Female; D005909:Glioblastoma / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology* / Q000601:surgery; D008297:Male; D008577:Meningeal Neoplasms / Q000473:pathology* / Q000556:secondary; D008875:Middle Aged; D011183:Postoperative Complications / Q000473:pathology*; D012307:Risk Factors; D016896:Treatment Outcome; D017287:Ventriculoperitoneal Shunt; D055815:Young Adult
keywords: Glioblastoma; Hydrocephalus; Leptomeningeal tumor dissemination; Neurosurgery; Ventriculoperitoneal shunt