RE-OPERATIVE CSF DIVERSION VERSUS DIRECT SURGICAL ATTACK IN POSTERIOR FOSSA TUMOURS WITH SECONDARY HYDROCEPHALUS

Zahran, Ahmed; Moharram, Hussein Alsayed; Hany, Mohamed Mostafa; Sabry, Hatem A.; Abdelmohsen, Ibrahim

doi:10.21608/asmj.2023.298320

RE-OPERATIVE CSF DIVERSION VERSUS DIRECT SURGICAL ATTACK IN POSTERIOR FOSSA TUMOURS WITH SECONDARY HYDROCEPHALUS

Document Type : Original Article

Authors

¹ Department of Neurosurgery, Faculty of medicine, Ain Shams University, Cairo, Egypt.

² Neurosurgery department, Faculty of medicine, Ain Shams University, Cairo, Egypt.

10.21608/asmj.2023.298320

Abstract

Background: Posterior fossa tumors could usually be complicated by secondary hydrocephalus due to obstruction or compression of the 4th ventricle. Aim of the work: To analyze the efficacy of preoperative CSF diversion versus direct tumour attack in long-term management of hydrocephalus. Patients and Methods: A retrospective study carried out on 30 patients presenting with posterior fossa tumors and secondary obstructive hydrocephalus managed at Ain Shams University Hospitals. Results: About one third of posterior fossa tumour patients become shunt dependent, surgical excision alone could be life threatening. Midline posterior fossa tumors were associated with a higher incidence of shunt dependance compared with those that only affected the cerebellar hemispheres or the CPA. Conclusion: Less than one-third of patients with posterior fossa tumours require a CSF diversion during the course of their illness, the fact that refutes the role of prophylactic shunting or ETV. However, higher post-operative morbidity and mortality in cases with direct tumour attack raises the protective role of preoperative CSF diversion especially in midline posterior fossa tumours.
Recommendations: Finally, previous results may need to be strengthened in the future study of more cases.

Main Subjects