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Abstract
Summary
Posterior fossa tumors account for approximately 60 % of brain tumours in children and due to the proximity of these tumors to the fourth ventricle and pathway of cerebrospinal fluid, hydrocephalus is present in about 90% of these cases. Hydrocephalus is responsible in most instances for the development of the manifestations of raised ICP, that bring the patients with posterior fossa tumors to the neurosurgeon. Dealing with hydrocephalus in those patients is a difficult work and is a matter of controversy in the literatures.
Many neurosurgeons prefer the diversion of CSF before the excision of the tumour, others are insisting to excise the tumour directly without diversion.
Aiming to evaluate the role of CSF diversion procedures and reach to the best protocol for management of hydrocephalus complicating posterior fossa tumours, we carried out this study.
This was a retrospective descriptive study, where (88) patients diagnosed as midline posterior fossa tumours who were treated within the last ten years from March 1995 till February 2005 will be included.
This study was done in Neurosurgery Department, Suez Canal University Hospital, Ismailia, EGYPT.
Included in this study all patients with the following:
1. Age below 15 years.
2. Patients with CT and/or MRI scans showing midline posterior fossa tumours.
3. Patients with CT and/or MRI scans showing signs of hydrocephalus.
Excluded from this study all patients with the following:
1. Sever hydrocephalus with severe altered level of consciousness.
2. Laterally situated tumours.
3- Non neoplastic mass.
Data were obtained from the patients or from the medical records and files of the patients and All patients were assessed through the following steps:
Clinical assessment
I-Full history taking:
• Personal history. • Compliant • Present history • Past history
II-General examination.
III-Neurological examination.
IV- Investigations: 1-Plain x-rays 2-CT brain
3- MRI brain and lumbosacral spine 4- Pathology of the tumour
V-Operative data. 1- CSF drainage 2- Operative position
3- Tumor excision 4- Closure of dura
5- Other procedures
VI – Postoperative clinical follow up
VII - Postoperative follow up by CT scan
VIII -Postoperative Complications
METHODS OF STATISTICAL ANALYSIS:
Numerical data are presented in the form of mean ± standard deviation (S.D) non numerical data are expressed as percentage. Probability (P) value less than 0.05 was considered statistically significant, and the probability (P) is insignificant for most table due to small number of patients.