Hydrocephalus after resection and adjuvant radiochemotherapy in patients with glioblastoma

Clin Neurol Neurosurg. 2014 May:120:27-31. doi: 10.1016/j.clineuro.2014.02.012. Epub 2014 Feb 25.

Abstract

Objective: Glioblastomas are the most common primary malignant brain tumors in adults with a poor prognosis. The current study sought to identify risk factors in glioblastoma patients that are closely associated with communicating hydrocephalus.

Methods: We retrospectively analyzed data from 151 patients who were diagnosed with a glioblastoma between 2007 and 2011 and underwent complete surgical resection closely followed by adjuvant radiochemotherapy.

Results: We observed a significant tendency toward communicating hydrocephalus in cases of ventricular opening during surgical tumor resection (Fisher's exact test p<0.001) and a noticeable, although not statistically significant, correlation between the onset of communicating hydrocephalus and evidence of leptomeningeal tumor dissemination (Fisher's exact test p=0.067). Additionally, there was a trend toward frontal tumor location and a larger tumor volume in patients with communicating hydrocephalus. The majority of patients suffering from communicating hydrocephalus received a cerebrospinal fluid (CSF) shunt implantation after radiation therapy (63.6%, Fisher's exact test p=0.000).

Conclusion: We identified the following risk factors associated with the onset of communicating hydrocephalus in glioblastoma patients: ventricular opening during tumor resection and leptomeningeal tumor dissemination. Shunt implantation seems to be safe and effective in these patients.

Keywords: Glioblastoma; Hydrocephalus; Leptomeningeal tumor dissemination; Neurosurgery; Ventriculoperitoneal shunt.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Brain Neoplasms / pathology
  • Brain Neoplasms / surgery
  • Brain Neoplasms / therapy*
  • Cerebral Ventricles / surgery*
  • Chemoradiotherapy, Adjuvant
  • Craniotomy
  • Female
  • Glioblastoma / pathology
  • Glioblastoma / surgery
  • Glioblastoma / therapy*
  • Humans
  • Hydrocephalus / etiology*
  • Hydrocephalus / surgery
  • Male
  • Meningeal Neoplasms / pathology*
  • Meningeal Neoplasms / secondary
  • Middle Aged
  • Postoperative Complications / pathology*
  • Risk Factors
  • Treatment Outcome
  • Ventriculoperitoneal Shunt
  • Young Adult