Delayed Hydrocephalus after Resection of Supratentorial Malignant Gliomas |
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Authors: | G Marquardt M Setzer J Lang V Seifert |
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Institution: | (1) Neurosurgical Clinic, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany, DE |
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Abstract: | Summary.
Summary.
Background: To report our experience with 12 patients who developed delayed hydrocephalus after resection of supratentorial malignant
gliomas.
Method: The charts of all affected patients were analysed retrospectively for clinical presentation, time interval between initial
operation and occurrence of hydrocephalus, neuroradiological findings, constituents of cerebrospinal fluid (CSF), surgical
treatment, and outcome.
Findings: After initial good recovery following tumour resection all patients deteriorated secondarily due to development of hydrocephalus
which was not encountered in the first postoperative CT-scans. Incidence is 3.4% overall and is 8.3% if exclusively calculated
for frontal gliomas but increases to 15.2% if specified for patients with ventricular entry during tumour resection. Development
of hydrocephalus is suggested to be due to proteinic precipitation since analysis of CSF revealed marked elevation of proteins
in all patients. Whereas shunting of mere hydrocephalus yields satisfactory results outcome in cases of multiloculated hydrocephalus
necessitating placement of multiple catheters is questionable.
Interpretation: Development of hydrocephalus after resection of malignant gliomas is not rare. It should be considered in patients with delayed
deterioration after initial improvement. Outcome in relation to hydrocephalus is favourable in cases of mere communicating
hydrocephalus, occurrence of multiloculated hydrocephalus, however, heralds a poor prognosis. |
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Keywords: | : Hydrocephalus malignant glioma complication |
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