Preoperative Cerebrospinal Fluid Diversion in Pediatric Posterior Fossa Tumor–Associated Hydrocephalus: Ventriculoperitoneal Shunt vs. External Ventricular Drainage

Abstract

Objective:  Assess the effectiveness of preoperative strategies of cerebrospinal fluid (CSF) diversion in children with posterior fossa tumors and related hydrocephalus.

Materials & Methods:  The sample size of seventy pediatric patients (1-14 years) with hydrocephalus due to the presence of the posterior fossa tumors was taken. Ventriculoperitoneal (VP) shunting or external ventricular drainage (EVD) was used to treat patients. The complications that were recorded after the operations, and patients were monitored after three.

Results:  The mean age was 5.76 ± 3.589 years, and 58.6% were male. In 57.1 and 42.9 percent of patients, VP shunt and EVD were done, respectively. The number of cases of CSF leak was much lower in the VP shunt group (12.5% vs EVD 33.3, P < 0.05). Other complications were also found more common in the EVD group but insignificant: Post-operative meningitis was found 2 times (5.820% ) in EVD compared to non-EVD, with pseudomeningocele, which was found 3 times out of seven patients, and which is an infection rate of 42 percent with no significant difference in both groups (p=0.584).

Conclusion:  Pediatric patients having hydrocephalus due to posterior fossa tumors will have fewer postoperative complications when the VP shunts are preoperative in comparison to EVD.

Keywords:  Pediatric Neurosurgery, Complications, Hydrocephalus, Posterior Fossa Tumors, VP shunt, EVD.