Santos de Oliveira Ricardo, Barros Jucá Carlos Eduardo, Valera Elvis Terci, Machado Hélio Rubens
Division of Pediatric Neurosurgery, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, 14049-900, Brazil.
Childs Nerv Syst. 2008 Dec;24(12):1397-403. doi: 10.1007/s00381-008-0649-x. Epub 2008 May 31.
We searched for factors that could predispose towards persistent hydrocephalus in children with posterior fossa (PF) tumors in order to determine the need for permanent cerebrospinal fluid (CSF) diversion.
The clinical records of 64 children who underwent surgery for PF tumors in the Pediatric Neurosurgery division of the Hospital of Clinics, Ribeirao Preto, Brazil, from 1990 to 2006, were retrospectively reviewed. The patients' ages ranged from 3 months to 18 years. The factors evaluated included age at surgery, severity of hydrocephalus (ventricular index), tumor location, size of the tumor, extent of tumor resection, and histology.
Ventricular index, measured from the initial neuroradiological image, age at surgery, and location of the tumor were significantly associated with definitive postoperative CSF diversion (shunt or endoscopic third ventriculostomy), which was necessary for 34% of the patients.
Young children with severe preoperative hydrocephalus and a midline tumor should be considered at risk when preoperative treatment decisions are made.
我们探寻后颅窝（PF）肿瘤患儿发生持续性脑积水的易感因素，以确定是否需要永久性脑脊液（CSF）分流。
回顾性分析1990年至2006年在巴西里贝朗普雷图临床医院小儿神经外科接受PF肿瘤手术的64例患儿的临床记录。患者年龄从3个月至18岁不等。评估的因素包括手术年龄、脑积水严重程度（脑室指数）、肿瘤位置、肿瘤大小、肿瘤切除范围及组织学类型。
根据最初的神经影像学图像测量的脑室指数、手术年龄及肿瘤位置与术后确定性CSF分流（分流术或内镜下第三脑室造瘘术）显著相关，34%的患者需要进行该分流术。
术前制定治疗决策时，应将术前脑积水严重且为中线肿瘤的幼儿视为高危人群。
