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Journal of Korean Neurosurgical Society > Volume 32(6); 2002 > Article
Journal of Korean Neurosurgical Society 2002;32(6): 535-542.
Therapeutic Results of Posterior Fossa Tumors with Hydrocephalus.
Il Seung Choe, Dae Hee Seo, Woo Tack Rhee, Sung Choon Park, Euy Byung Chae, Suck Jun Oh
1Department of Neurosurgery, College of Medicine, Kwandong University, Myongji Hospital, Goyang, Korea. nscis@kwandong.ac.kr
2Department of Neurosurgery, College of Medicine, Hanyang University, Seoul, Korea.
This study is designed to identify the clinical characteristics and the optimal treatment modality of hydrocephalus in posterior fossa tumors.
The authors reviewed 154 infratentorial tumor patients. Age, sex, clinical symptoms, types of treatment, and surgical results of posterior fossa tumor patients with hydrocephalus were analyzed, retros-pectively. Factors which might predict the need for external ventricular drainage(EVD) or ventriculo-peritoneal shunt were analyzed statistically.
Hydrocephalus was noted in 86 cases(56%), and it was associated with medulloblastoma in 16 cases(89%), hemangioblastoma in 12(63%) and brain stem glioma in three(33%). The surgical results of the posterior fossa tumors with hydrocephalus were poorer than those without hydrocephalus(p<0.05). A large tumor(p<0.05) and an incomplete removal(p<0.05) were factors predicting the need for EVD or shunt. Complications of intraoperative EVD or shunt developed in four cases. They were infection, he-morrhage at puncture site, and obstruction. Five patients in whom intraoperative EVD or shunt had not been performed developed a fatal hydrocephalic attack at immediate postoperative period, and the pos-toperative computed tomography scan revealed intraventricular hemorrhages in three cases cerebellar swellings in two cases.
Intraoperative EVD or shunt is a safe, effective treatment modality especially in large size tumor and/or incomplete tumor resection. Intraventricular hemorrhages or cerebellar swellings during immediate postoperative period might cause fatal hydrocephalic attack, therefore EVD or shunt might be recommended in selected cases.
Key Words: Posterior fossa tumor; Hydrocephalus; External ventricular drain; Shunt
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