Management of Hydrocephalus in Posterior Cranial Fossa Tumors

Treatment of hydrocephalus in posterior fossa tumors in children is still a matter ofcontroversy and different centers have their own routines. in this regard, hospital records of all childrenwith posterior fossa tumors treated in our center during the interval of 1985-1995 were reviewed.patients’ demographic and diagnostic data were analyzed and the frequencies of shunting procedureswere determined. fisher exact test was employed to compare the frequency of postoperativecomplications in different groups. a total of 108 patients with age ranging from 3 months to 18 yearsand a male to female ratio of 1.5 comprised the study population. ninety-nine cases had hydrocephalusat the time of diagnosis and 81 patients underwent preoperative shunting. of the remaining 18 patients,13 underwent external ventricular drainage at tumor operation session plus preoperative corticosteroidtherapy. the rest of the patients got no primary treatment for hydrocephalus. three of these 5 patientshad postoperative shunting after tumor removal, but the other 2 remained shunt free. the rate ofpostoperative complications including cerebrospinal fluid leakage and septic meningitis weresignificantly lower in patients with preoperative shunting. the results of this study are in favor of thosethat approve the effect of preoperative shunting in decreasing postoperative complications. this is wellestablished when the tumor size is big or when the diagnosis of posterior fossa tumor is made in laterstages or when hydrocephalus is severe. it could be concluded that preoperative shunting can decreasethe rate of postoperative complications.