Postoperative Hydrocephalus in Cranial Base Surgery

Duong, D. Hoang; O’Malley, Sean M.; Sekhar, Laligam N.; Wright, Donald G.

doi:10.1055/s-2000-9331

Cited by 41 publications

(40 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…6 Although causes and factors influencing the occurrence of true postoperative hydrocephalus are still unknown, our data demonstrate that this disorder is more likely to occur after meningioma extirpation in the skull base region compared with other locations, as has been suggested by others. 6,11 One theory argues that intraoperative spillage of blood into cisterns and subarachnoid space during surgery may lead to a malresorptive hydrocephalus. 6 The more complex nature of the surgical treatment of skull base meningiomas, showing extensive infiltration of the connective and osseous tissues of the skull base, support this hypothesis.…”

supporting

confidence: 58%

“…Our overall incidence of hydrocephalus, at 5.9%, is in concordance with other studies showing incidence rates ranging from 2% to 13%. 3,6,12,21 The wide range reported in the literature thus far is most likely due to the different localizations of the meningiomas included in these studies. For instance, Duong et al 6 showed a postoperative hydrocephalus incidence rate of 8% for meningiomas located in the skull base region, and Boviatsis et al 3 described a rate of 6.9% for supratentorial meningiomas.…”

Section: Discussionmentioning

confidence: 93%

“…3,6,12,21 The wide range reported in the literature thus far is most likely due to the different localizations of the meningiomas included in these studies. For instance, Duong et al 6 showed a postoperative hydrocephalus incidence rate of 8% for meningiomas located in the skull base region, and Boviatsis et al 3 described a rate of 6.9% for supratentorial meningiomas. In contrast, Tahara et al 21 reported a higher hydrocephalus incidence rate of 13.3% for petroclival meningiomas, which is confirmed by our results (16.6%) in patients with meningiomas located in the posterior part of the skull base.…”

Section: Discussionmentioning

confidence: 93%

“…6,11 One theory argues that intraoperative spillage of blood into cisterns and subarachnoid space during surgery may lead to a malresorptive hydrocephalus. 6 The more complex nature of the surgical treatment of skull base meningiomas, showing extensive infiltration of the connective and osseous tissues of the skull base, support this hypothesis. 11 Furthermore, it has been shown in patients with subarachnoid hemorrhage that malresorptive hydrocephalus may be caused by blood products clogging the arachnoid villi.…”

mentioning

confidence: 99%

“…3,4,6,12,14,15,19 True postoperative hydrocephalus needs to be distinguished from the occurrence of transient obstructive hydrocephalus, which is most frequently due to the mass effect of the meningioma present before surgery. 6 Although causes and factors influencing the occurrence of true postoperative hydrocephalus are still unknown, our data demonstrate that this disorder is more likely to occur after meningioma extirpation in the skull base region compared with other locations, as has been suggested by others. 6,11 One theory argues that intraoperative spillage of blood into cisterns and subarachnoid space during surgery may lead to a malresorptive hydrocephalus.…”

mentioning

confidence: 99%

See 4 more Smart Citations

Predicting postoperative hydrocephalus in 227 patients with skull base meningioma

Burkhardt

Zinn

Graenicher

et al. 2011

FOC

View full text Add to dashboard Cite

Object Some patients develop communicating hydrocephalus after meningioma surgery, and this can develop into a serious clinical condition. However, this has rarely been addressed in the literature. Therefore, the authors sought to determine predictive patient variables for the occurrence of postoperative hydrocephalus following skull base meningioma surgery. Methods For this purpose, the authors retrospectively analyzed all patients who underwent resection of intracranial meningiomas between 1998 and 2009 at the Department of Neurosurgery, University Hospital Zurich, Switzerland. Of 594 patients with meningioma, 227 (38%) had a lesion located at the skull base, and thus were included for analysis. The following patient variables were examined: demographic data (age and sex); tumor number (solitary vs multiple); tumor side and localization within the skull base region (anterior, medial, posterior); infiltration of the cavernous sinus; compression of the optic channel/optic nerve; tumor volume; preoperative embolization (yes/no); duration of surgery; Simpson grade of resection; histopathological features (WHO grade); number of surgeries (single vs multiple); preoperative embolization; duration of hospital stay; tumor recurrence; use of an artificial dural substitute; postoperative infection rate; and clinical outcome (Glasgow Outcome Scale score at discharge and at 3 months, and vital status at last follow-up). Hierarchical clustering, factor analysis, and stepwise regression models revealed a ranking list for the top predictive variables for the occurrence of postoperative hydrocephalus. Results A total of 35 patients (5.9%) of the cohort of 594 developed communicating postoperative hydrocephalus, with no patient manifesting obstructive hydrocephalus. Of these 35 patients, 18 had a meningioma located at the skull base (18 [7.9%] of 227), in contrast to 17 patients with meningiomas in other locations (17 [4.6%] of 367). The following patient variables correlated with the occurrence of hydrocephalus, as defined by factor analysis: age, duration of surgery, duration of hospital stay, tumor volume, postoperative infection, and preoperative embolization. A stepwise regression analysis of the latter variables identified 2 variables as significantly predictive: age (p = 0.0012) and duration of surgery (p = 0.0013). Conclusions In this study, the incidence of communicating postoperative hydrocephalus was almost twice as high in patients with skull base lesions as in patients with meningiomas in other locations. Patient age, duration of surgery, duration of hospital stay, tumor volume, postoperative infection, and preoperative embolization were associated with the occurrence of hydrocephalus. In the statistical prediction model, patient age and duration of surgery were the most significant predictors of postoperative hydrocephalus after skull base meningioma surgery.