From: Hydrocephalus with lateral ventricular lesions: case series and review of literature
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Age | 15 years | 6 years | 8 years | 25 years | 20 years | 45 years | 15 years | 19 years | 55 years | 18 years | 46 years |
Sex | Female | Male | Female | Female | Female | Female | Female | Male | Female | Female | Female |
Preoperative hydrocephalus | + | + | − | − | + | + | + | + | + | + | + |
Surgical approach | Transcortical left middle frontal gyrus | Transcortical left middle frontal gyrus | Transcortical right superior parietal lobule | Transcortical right superior parietal lobule | Transcortical right superior parietal lobule | Transcortical right superior parietal lobule | Transcortical right superior parietal lobule | Transcortical left superior parietal lobule | Transcortical right middle frontal gyrus | Transcortical middle frontal gyrus | Transcallosal |
Gross excision | Total | Total | Total | Total | Total | Total | Total | Total | Total | Total | Total |
EVD | + | − | − | − | + | + | + | + | + | + | + |
Fate or postoperative hydrocephalus | Postoperative CT revealed ventriculomegaly and EVD pressure was high. | Subgalial collection after 2 weeks. then After 1-month CT revealed subdural effusion with no ventriculomegaly. | Headache after 2 weeks. CT revealed accumulated CSF along the corridor of surgery. Then After 1-month CT showed more CSF accumulated along the corridor and enlarged ipsilateral temporal horn. | Immediate CT postoperative revealed early hydrocephalic changes and small hematoma at tumor bed. Clinically there was mild manifestation of increased ICP with no clinical deterioration on follow up. After 3 days hydrocephalus resolved. | EVD pressure readings are borderline for 2 days. The EVD removed and the patient followed up. 5 days later subgalial collection developed and CT showed hydrocephalic signs and ventriculomegaly. | CSF pressure was low for 2 days, the EVD was removed. | The tumor was huge and very vascular with intraoperative excess bleeding and the patient postoperative GCS was 5. CT postoperative revealed ventriculomegaly and EVD pressure readings was high. The patient died after 10 days. | Immediate CT postoperative revealed Intraventricular hematoma. EVD was used for drainage of blood for 3 days then another 3 days for measuring CSF pressure which was borderline and the EVD was removed. 3 days later subgalial collection developed and ventriculomegaly appears in CT brain. | CSF pressure readings was border line. Unfortunately, the patient started to experience fever from 2nd day after surgery due to ventriculitis. So the EVD was not removed (changed after 10 days) and the patient died after 20 days. While the 20 days the EVD pressure readings raised. CT started to reveal subdural effusion from the 5th day as sign of increased intracranial pressure. | CSF pressure readings was low for 3 days and EVD was removed. 8 days after surgery subgalial collection developed and ventriculomegaly started to appear in CT. | CSF pressure was high. Unfortunately, the patient started to experience fever from 3rd day after surgery and CSF TLC was high (ventriculitis). Postoperative GSC was 8. The EVD was not removed and the patient died after 9 days. While that time CT follow-up revealed ventriculomegaly. |
Lumbar manometry | − | Done twice | − | − | − | − | − | − | − | − | − |
Permanent CSF diversion | + VPS | + VPS | + VPS | − | + VPS | − | − | + VPS | − | + VPS | − |
Pathology | Central neurocytoma | Subependymal giant cell astrocytoma | AVM | Meningioma G1 | Astrocytoma G2 | Meningioma G1 | Central neurocytoma | Central neurocytoma | Oligodendroglioma | Pilocytic astrocytoma | Subependymoma |
Complication | − | − | − | − | − | − | Excessive intraoperative bleeding | Postoperative intraventricular bleeding | ▪ Injury to deep vein resulting in thalamic infarction. ▪ Ventriculitis | − | Ventriculitis |