PROGNOSTIC SIGNIFICANCE OF PRE AND POST-RESECTION HYDROCEPHALOUS MANAGEMENT IN PAEDIATRIC POSTERIOR FOSSA TUMOURS; A TWO YEARS PROSPECTIVE SERIE
Background: Posterior fossa tumours are one of the commonest malignancies of childhood. Most of them presents
with concomitant hydrocephalous and majority require pre-resection CSF diversion procedures such as VP shunt,
EVD or ETV.
Methods: This study was conducted in a prospective manner from January 2013 to December 2014 at the department
of Neurosurgery, Hayatabad Medical Complex Peshawar. The clinical effectiveness of CSF diversion procedures was
assessed in terms of Glasgow outcome score.
Results: A total of 25 patients were included with a male to female ratio of 1:3. The majority of patients presented with
concomitant hydrocephalous and most (72%) of them underwent VP shunt or ETV procedures preoperatively. 28%
of patients underwent CSF diversion post-resection. There was a significant correlation between pre-resection CSF
diversion and functional outcome with an Odds ratio of 2.722 (95% CI .822-9.011) and .311 (95% CI .116-.832) for
favourable and unfavourable outcome groups, respectively.
Conclusion: CSF diversion before definitive resection of posterior fossa tumours in paediatric patients is a simple and
effective procedure. This study has highlighted the positive role which this intervention can play in improving the final
outcome. Larger and long term studies are however needed in order to fully elucidate the role of these procedures.
Keywords: Posterior fossa tumours, CSF diversion, VP shunt, ETV, Outcome, Paediatric
Abbreviations: CSF: Cerebrospinal fluid, VP Shunt: Ventriculoperitoneal shunt, ETV: Endoscopic third ventriculostomy