MANAGEME.NT OF HYDROCEPHALUS COMPLICATING POSTERIOR FOSSA TUMORS IN CHILDREN

Abstract

Posterior fossa tumors in children namely medulloblastomas, cerebellar astrocytomas, ependymomas, and brainstem gliomas are commonly complicated by obstructive hydrocephalus due to obstruction of the fourth ventricle, kinking or distortion of aqueduct of Sylvius. This hydrocephalus is responsible in most instances for the development of signs and symptoms of increased ICP that usually preceed the manifestation of cerebellar or brain stem dysfunction. The present study included 30 cases having hydrocephalus secondary to posterior • fossa tumors, managed by different lines to study the indications, advantages, and disadvantages of these different lines. V-P shunts were placed in some cases as a preliminary treatment. External drainage systems were placed before tumor removal in other cases. While, in some cases the tumor was removed without preliminary CSF diversion.

The age incidence ranged from 3 months to 12 years with a mean age of 5.2 years.

The most common clinical presentations were these of increased intracranial pressure (headache in 76.7%, vomiting in 83.3%, disturbed gait in 86.7%, lethargy in 63.3%, and double vision in 43.3%). The most common clinical findings were ataxia (in 86.7%),

papilloedema (in 80%), nystagmus (in 36. 7%), and disturbed

consciousness (in 23.3%).