Role of cerebrospinal fluid diversion in posterior fossa tumor surgery.

OBJECTIVE To assess the role of cerebrospinal fluid diversion in posterior fossa tumor surgery. DESIGN Descriptive study. PLACE AND DURATION OF STUDY This study was conducted at the Department of Neurosurgery, Pakistan Institute of Medical Sciences (PIMS), Islamabad from February 2000 to July 2002 over a period of two and-a-half years. SUBJECTS AND METHODS Clinical, radiological and operative records of the patients who were operated for posterior fossa tumors were studied. Absolute and relative frequencies of the patients who were managed with external ventricular drainage (EVD) or ventriculoperitoneal shunt (VPS) were determined. Mean age and male to female ratio were also noted. RESULTS There were 48 patients who were operated for posterior fossa tumors. Mean age was 23 years. Male to female ratio was 1.2:1. VPS was done in 14 patients (29%) pre-operatively, in one patient (2%) per-operatively and in 2 patients (4%) postoperatively. EVD was done in 33 patients out of whom 2 patients were shunted post-operatively. Sixty-five percent of the patients remained shunt-free. CONCLUSION Although management of hydrocephalus secondary to posterior fossa tumors is controversial, majority of the patients need temporary cerebrospinal fluid diversion