Single-Center Retrospective Analysis of Risk Factors for Hydrocephalus After Lateral Ventricular Tumor Resection

Chengda Zhang; Lingli Ge; Zhengwei Li; Tingbao Zhang; Jincao Chen

doi:10.3389/fsurg.2022.886472

Single-Center Retrospective Analysis of Risk Factors for Hydrocephalus After Lateral Ventricular Tumor Resection

Front Surg. 2022 Jun 16:9:886472. doi: 10.3389/fsurg.2022.886472. eCollection 2022.

Authors

Chengda Zhang^{1

2}, Lingli Ge³, Zhengwei Li¹, Tingbao Zhang¹, Jincao Chen¹

Affiliations

¹ Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, China.
² Department of Neurosurgery, The Affiliated Hospital of Hubei University of Medicine, The First People's Hospital of Xiangyang, Xiangyang, China.
³ Department of Paediatrics, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, The Central Hospital of Xiangyang, Xiangyang, China.

Abstract

Objective: There is no general consensus on the placement of preoperative and intraoperative external ventricular drainage (EVD) in patients with lateral ventricular tumors (LVTs). The aim of this study was to identify the predictors of postoperative acute and persistent hydrocephalus need for postoperative cerebrospinal fluid (CSF) drainage and guide the management of postoperative EVD in patients with LVTs.

Methods: We performed a single-institution, retrospective analysis of patients who underwent resection of LVTs in our Department between January 2011 and March 2021. Patients were divided between one group that required CSF drainage and another group without the need for CSF drainage. We analyzed the two groups by univariate and multivariate analyses to identify the predictors of the requirement for postoperative CSF drainage due to symptomatic intracranial hypertension caused by hydrocephalus.

Results: A total of 97 patients met the inclusion criteria, of which 31 patients received preoperative or intraoperative EVD. Ten patients without prophylactic EVD received postoperative EVD for postoperative acute hydrocephalus. Eleven patients received postoperative ventriculoperitoneal(VP) shunt subsequently. Logistic regression analysis showed that tumor invasion of the anterior ventricle (OR = 7.66), transependymal edema (OR = 8.76), and a large volume of postoperative intraventricular hemorrhage (IVH) (OR = 6.51) were independent risk factors for postoperative acute hydrocephalus. Perilesional edema (OR = 33.95) was an independent risk factor for postoperative VP shunt due to persistent hydrocephalus.

Conclusion: Postoperative hydrocephalus is a common complication in patients with LVTs. These findings might help to determine whether to conduct earlier interventions.

Keywords: CSF drainage; EVD; VP shunt; hydrocefalus; lateral ventricular tumor.