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Management of Hydrocephalus in Brain Tumors to Fann Teaching Hospital in Dakar.

Introduction: Tumoral hydrocephalus (TH) is an increasingly common pathology in our service. It is a diagnostic and especially therapeutic emergency. Its treatment is mainly surgical and the prognosis closely depends on the type of tumor. The objective of our study was to determine the efficiency of the various bypass procedures used for the treatment of hydrocephalus in patients with brain tumors. Patients and Methods: We conducted a retrospective study of 146 patients with tumoral hydrocephalus, collected from 1 January 2014 to 31 December 2018 (5 years) in the Neurosurgery Department of Fann Teaching Hospital. Results: The frequency of tumoral hydrocephalus cases in our series was rated at 25% of all hydrocephalus operated during this period with 29.2 cases per year. The sex ratio was 1.39 with a mean age of 35 years (range from 1 month to 77 years). Children under 15 accounted for 53.42%. Cerebral computed tomography (CT) was performed in 93.75% of patients and magnetic resonance imaging (MRI) in 20.83%. Tumors of the posterior fossa (PFT) accounted for 60.3% followed by ventricular tumors 15.5% and sellar 7.5%. Surgically, endoscopic third ventriculostomy (ETV), ventriculoperitoneal shunt (VPS), and external ventricular derivation (EVD) were performed respectively in 58.24%, 30.13% and 10.27% of cases. The surgical average time was 3 days with extremes of 24h and 150 days. Two patients benefited from a ventriculo –atrial shunt (VAS) complementary to the persistence of hydrocephalus. The main complications were ascites of great abundance in 4 patients and infections in 10 patients (6.84%). In our series, 30.82% (45 patients) received additional etiological treatment. The average time between the two interventions was 14 days. We noted 17 cases of death including 7 cases attributed to hydrocephalus. Conclusion: The endoscopic third ventriculostomy is currently the gold standard as an alternative to other methods in the management of tumoral hydrocephalus, but remains a palliative treatment. Etiological treatment is the core therapeutic approach for this hydrocephalus.


Auteur(s) : Alioune Badara Thiam, Maguette Mbaye, Rel Gerald Boukaka Kala, Mbaye Thioub, Cheick Ndiaye SY, Mohamet Faye, Sarah Mutomb Ntshindj, Ndaraw Ndoye, Moma
Pages : pp.1-6
Année de publication : 2020
Revue : International Journal of Neurosurgery
N° de volume : Vol. 4, No. 1
Type : Article
Mise en ligne par : THIAM Alioune Badara