ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2023
Perioperative external ventricular drainage vs. no-EVD strategy in pediatric posterior fossa tumors-pilot study results.
Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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5 citing papers in PubMed, 5 citations in OpenAlex.
- PITCH (pediatric infratentorial tumors - hydrocephalus-related complications) registry study design: observational, prospective, multicenter study evaluating the number of surgeries associated with the treatment of hydrocephalus secondary to infratentorial tumors in childhood and adolescence.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026Observational
- Cerebrospinal fluid cellular and inflammatory profiles in tumor-related postoperative infections: influencing factors and clinical features in oncological patients.American journal of cancer research · 2026Article
- Volumetric predictors for shunt-dependency in pediatric posterior fossa tumors.Scientific reports · 2025Article
- Validating the modified Canadian Preoperative Prediction Rule for Hydrocephalus for accurate hydrocephalus prediction in a statewide pediatric brain tumor cohort.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2025Article
- External ventricular drainage in pediatric patients: indications, management, and shunt conversion rates.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2024Article
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5 authors at 1 institution in 1 country.
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Abstract
introductionPediatric brain tumors of the posterior fossa often present with occlusive hydrocephalus. Endoscopic third ventriculostomy (ETV) or ventriculoperitoneal shunting (VPS) has been established for definite hydrocephalus treatment. The aim of the study was to analyze the impact and safety of perioperative temporary external ventricular CSF drainage (EVD) placement on postoperative hydrocephalus outcome compared to a no-EVD strategy. PATIENTS AND
methodsIn a prospective database, 36 posterior fossa tumor patients of 2-18 years were included with a follow-up of 1 year. Fifty-eight percent presented with preoperative hydrocephalus. Patients were assigned to non-hydrocephalus group: group I (n = 15) and to preoperative hydrocephalus, group IIa with EVD placement (n = 9), and group IIb without EVD (n = 12).
resultsMedian age of patients was 8.1 years (range 3.17 to 16.58 years). One-third of 21 hydrocephalus patients required ETV or VPS (n = 7). Occurrence of de novo hydrocephalus in group I after surgery was not observed in our cohort. Age and histology were no confounding factor for EVD placement between group IIa and IIb (p = 0.34). The use of EVD did not result in better control of hydrocephalus compared to no-EVD patients considering pre- and postoperative MRI ventricular indices (p = 0.4). Perioperative placement of an EVD resulted in a threefold risk for subsequent VPS or ETV (group IIa 55.5% vs group IIb 16.6%): relative risk for EVD patients compared to no-EVD patients with hydrocephalus was 3.3 (CI = 1.06-13.43, p = 0.09).
conclusionPerioperative EVD placement appears to harbor a threefold relative risk of requiring subsequent permanent CSF diversion in children above 2 years. EVD was not more effective to control ventricular enlargement compared to tumor removal alone. The no-EVD strategy was safe and did not result in postoperative complications. Thus, to evaluate potential adverse effects on hydrocephalus outcome by EVD placement, a prospective study is warranted to falsify the results.
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