Postoperative hydrocephalus management may cause delays in adjuvant treatment following paediatric posterior fossa tumour resection: a multicentre retrospective observational study

Background: Hydrocephalus is a relatively common occurrence in a children suffering from the posterior fossa tumour (PFTm). However, there is a divided opinion regarding the ventriculoperitoneal shunt (VPS) surgery before the posterior fossa tumour resection in a child. For the better clinical outcome, we should be able to predict which patient will require VPS following the resection of PFTm. Purpose of our retrospective analysis is to analyse various factors that predicts the necessity of VPS following PFTm resection.Methods: A consecutive series of twenty-six patients who underwent PFTm resection without undergoing VPS preoperatively are analysed in our series.Results: In our series, we found that the younger age at presentation, incomplete tumour resection, longer period of artificial ventilatory support, insertion of external ventricular drain (EVD) and its duration during the postoperative period correlate the necessity of VPS following PFTm resection. However, the severity of hydrocephalus prior to tumor surgery, tumour size, anatomical location of the tumour, tumour dissemination, use of Dural grafts during closure and histopathological type do not predict the requirement of the VPS following PFTm.Conclusions: Patients who are younger at diagnosis should be treated with utmost importance. Gross total resection should be the goal. Factors which predict the likelihood of the EVD which parallels the likelihood of postresection hydrocephalus must be prevented for the better clinical outcome.

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Subdural hygromas following posterior fossa tumour resection – A rare Complication

International Journal of Surgery ◽

10.1016/j.ijsu.2014.07.073 ◽

2014 ◽

Vol 12 ◽

pp. S22

Author(s):

Anokha Oomman ◽

Viswa Rajalingam ◽

Ravindra Nanapaneni

Keyword(s):

Posterior Fossa ◽

Rare Complication ◽

Tumour Resection ◽

Posterior Fossa Tumour

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THE PREVALENCE AND CLINICAL PROFILE OF PATIENTS PRESENTED WITH POSTERIOR FOSSA EXTRA DURAL HEMATOMA IN TERTIARY CARE HOSPITAL: A RETROSPECTIVE OBSERVATIONAL STUDY.

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i5.1378 ◽

2020 ◽

Vol 4 (5) ◽

Author(s):

Deepak Karn

Keyword(s):

Observational Study ◽

Posterior Fossa ◽

Early Recognition ◽

Tertiary Care ◽

Postoperative Outcome ◽

Clinical Profile ◽

Retrospective Observational Study ◽

Care Hospital ◽

The Mean ◽

Admission Glasgow Coma Scale

Aim: to determine the prevalence and clinical profile of patients presented with posterior fossa extra dural hematoma. Materials and Methods: The present retrospective observational study was conducted in the Department of Neurosurgery, SKMCH, Muzaffarpur, Bihar, India. The records were retrospectively analyzed for clinical presentation, admission Glasgow Coma Scale (GCS), mode of injury, type of intervention and postoperative outcome. Outcomes were assessed on the basis of Glasgow Outcome Score (GOS) at the time of discharge and at 3 months Results: Of these 39 patients, 28 were males and 11 females. The mean age of patients was 29.21 years. 24 patients had GCS 13-15 at admission followed by 9 with GCS 9-12 and only 5 of them had GCS <9 at admission. Mean EDH volume was 28.7 ml. 36 patients were operated, 5 patients managed conservatively. Conclusion: The posterior fossa is an uncommon site for epidural haematomas. Due to the small volume of the posterior fossa and contained important structures mortality can be high if the haematoma is missed. Clinical progress is silent and slow, but the deterioration is sudden and quick to become fatal if not promptly treated. Early recognition is extremely important. Keywords: Extradural hematoma, Posteriors fossa, GCS, Trauma

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Surgical site infection in paediatric posterior fossa surgery: does pathology matter?

Child s Nervous System ◽

10.1007/s00381-021-05131-w ◽

2021 ◽

Author(s):

Malik Zaben ◽

Alexandra Richards ◽

Joseph Merola ◽

Chirag Patel ◽

Paul Leach

Keyword(s):

Surgical Site Infection ◽

Posterior Fossa ◽

Csf Leak ◽

Tumour Resection ◽

Posterior Fossa Surgery ◽

Site Infection ◽

Significant Difference ◽

Paediatric Age ◽

Postoperative Hydrocephalus ◽

Brain Tumour Surgery

Abstract Objectives The aim of this study was to explore the rates and potential risks of surgical site infection (SSI) after posterior fossa surgery for tumour resection in children. Methods We retrospectively reviewed our local paediatric (age < 16 years) database for all cases of posterior fossa (PF) brain tumour surgery between November 2008 and November 2019. We collected patient demographics, tumour histology/location, and the event of postoperative surgical site infection. Results Overall, 22.1% (n=15) developed SSI out of sixty-eight children undergoing PF surgery for resection of brain tumours; 73.3% of them had a confirmed diagnosis of medulloblastoma. There was no statistically significant difference in the age (5.1 ± 0.60 vs. 6.2 ± 0.97 years; p=0.47) and duration of operation (262 vs. 253 min; p = 0.7655) between the medulloblastoma group and other tumours. Although the rate of postoperative hydrocephalus was higher in the medulloblastoma group (12.9% vs. 0%), this was not associated with increased SSI. Rates of CSF leak between the 2 groups were not different. Conclusion Medulloblastoma as a pathological entity seems to carry higher risk of postoperative surgical site infection compared to other types of paediatric posterior fossa tumours. Further larger studies are required to look into this causal relationship and other risk factors that might be involved.

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Neuropsychological long-term sequelae after posterior fossa tumour resection during childhood

Brain ◽

10.1093/brain/awg195 ◽

2003 ◽

Vol 126 (9) ◽

pp. 1998-2008 ◽

Cited By ~ 155

Author(s):

M. Steinlin

Keyword(s):

Posterior Fossa ◽

Tumour Resection ◽

Posterior Fossa Tumour

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Hemmkörperentwicklung bei Hämophilie-Patienten nach Präparate wechsel

Hämostaseologie ◽

10.1055/s-0037-1619773 ◽

2012 ◽

Vol 32 (S 01) ◽

pp. S39-S42 ◽

Cited By ~ 1

Author(s):

S. Kocher ◽

G. Asmelash ◽

V. Makki ◽

S. Müller ◽

S. Krekeler ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Observational Study ◽

Retrospective Observational Study ◽

Frequent Change ◽

Patient Age ◽

Treatment Regimens ◽

Patient Âgé ◽

The Relationship ◽

Observation Period

SummaryThe retrospective observational study surveys the relationship between development of inhibitors in the treatment of haemophilia patients and risk factors such as changing FVIII products. A total of 119 patients were included in this study, 198 changes of FVIII products were evaluated. Results: During the observation period of 12 months none of the patients developed an inhibitor, which was temporally associated with a change of FVIII products. A frequent change of FVIII products didn’t lead to an increase in inhibitor risk. The change between plasmatic and recombinant preparations could not be confirmed as a risk factor. Furthermore, no correlation between treatment regimens, severity, patient age and comorbidities of the patients could be found.

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