ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2026
Hydrocephalus in pediatric posterior fossa tumors: predictors and outcomes from a single center in Latin America.
Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Authors' Response to "Comments on 'Hydrocephalus in Pediatric Posterior Fossa Tumors: Predictors and Outcomes From a Single Center in Latin America'".Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026Article
- Perhaps we are asking the wrong question: should we predict permanent shunt dependency or understand why it develops?Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026Article
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Abstract
backgroundThe management of hydrocephalus in pediatric posterior fossa tumors remains highly variable. This study aims to analyze hydrodynamic factors and identify predictors of CSF diversion procedures in children undergoing posterior fossa tumor resection.
methodsA retrospective cohort study was conducted with pediatric patients who underwent posterior fossa tumor resections at a single center in Latin America. Poisson regression models were applied to analyze associations with ventriculomegaly, need for cerebrospinal fluid (CSF) diversion, postoperative hydrocephalus, and shunt dependence. Survival outcomes were assessed using Kaplan-Meier curve analysis.
resultsThe study analyzed 135 pediatric patients with posterior fossa tumors. Preoperatively, 71.85% had ventriculomegaly and 36.29% required CSF diversion. Postoperatively, 16.32% required new CSF diversion, and 25.93% remained shunt dependent. Multivariate analysis revealed that younger age, quadrigeminal cistern involvement, and metastasis were predictors of shunt requirement. Pilocytic astrocytomas were less prevalent among patients with hydrocephalus, while PNET/ATRT were more common. Postoperative hydrocephalus was linked to solid tumors, midline location, and metastasis. "Other embryonal tumors" had a 1.4 times higher likelihood of requiring a VPS postoperatively. The degree of tumor resection was not significantly associated with postoperative hydrocephalus. Considering shunt dependence, patients with ependymomas had a 1.56 times higher likelihood of persistent hydrocephalus. The 5-year OS rate was lower in patients with hydrocephalus (69.4% vs 90.7%).
conclusionTumor resection alone may not suffice to prevent hydrocephalus, particularly in younger children and those with ependymomas. High shunt dependency and related complications highlight the importance of early identification and careful patient selection for CSF diversion.
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