====== Obstructive hydrocephalus from posterior fossa tumor treatment ======

{{rss>https://pubmed.ncbi.nlm.nih.gov/rss/search/1BqdMZQc79aiOlWM_QMv1NK_E6nf0Q-KdxJkBApqHuuniMX1A5/?limit=15&utm_campaign=pubmed-2&fc=20230710071801}}
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Hydrocephalus associated with posterior fossa tumor affects the quality of life of patients with such lesions. Routine preoperative CSF diversion is not necessary for the vast majority of patients with posterior fossa tumor-related hydrocephalus. A high index of suspicion and aggressive surveillance is required for the early identification and appropriate management of postresection hydrocephalus
((Muthukumar N. Hydrocephalus Associated with Posterior Fossa Tumors: How to Manage Effectively? Neurol India. 2021 Nov-Dec;69(Supplement):S342-S349. doi: 10.4103/0028-3886.332260. PMID: 35102986.))
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[[Ommaya reservoir]] can produce good results through simple surgical procedures for the treatment of acute hydrocephalus in children with posterior fossa tumors and is associated with less trauma and complications
((Ji W, Liang P, Zhou Y, Li L, Zhai X, Xia Z. [Management of obstructive hydrocephalus before posterior fossa tumor resection in children]. Nan Fang Yi Ke Da Xue Xue Bao. 2013 Nov;33(11):1696-8. Chinese. PMID: 24273282.)).
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Schmid and Seiler employed a high dose of steroids after diagnosis; a frontal [[ventricular catheter]] with a subcutaneous fluid reservoir (Rickham) was inserted within 2 to 5 days; a temporary external ventricular drainage system was attached to the reservoir if, despite the steroids, intracranial pressure was over 30 cm H2O; and tumor excision was performed within 5 days to reopen the cerebrospinal fluid (CSF) pathways. In view of the wide range of potential complications, it was decided not to use a shunt before craniotomy. A shunt was inserted only if the CSF pathways remained obstructed after tumor removal. With this regimen, 93% of all patients (100% of the adults and 83% of the children) were shunt-free after the operation, without fatal complications. The infection rate was 4.9%. It was concluded that the severity of symptoms of raised intracranial pressure from hydrocephalus, the intraventricular pressure, and the size or location of the tumor prior to surgery do not have prognostic value as to which patients will require a shunt after surgery
((Schmid UD, Seiler RW. Management of obstructive hydrocephalus secondary to posterior fossa tumors by steroids and subcutaneous ventricular catheter reservoir. J Neurosurg. 1986 Nov;65(5):649-53. doi: 10.3171/jns.1986.65.5.0649. PMID: 3772453.)).