Alexandre Roux1, Céline Botella2, Megan Still3, Marc Zanello1, Frédéric Dhermain4, Philippe Metellus5, Johan Pallud6. 1. Department of Neurosurgery, Sainte-Anne Hospital, Paris, France; Paris Descartes University, Sorbonne Paris Cité, Paris, France; Inserm, U894, IMA-Brain, Centre de Psychiatrie et Neurosciences, Paris, France. 2. Department of Neurosurgery, Sainte-Anne Hospital, Paris, France; Paris Descartes University, Sorbonne Paris Cité, Paris, France; Department of Neurosurgery, Henri-Mondor Hospital, Créteil, France. 3. Department of Neurosurgery, Sainte-Anne Hospital, Paris, France; University of Texas Southwestern Medical Center, Dallas, Texas, USA. 4. Department of Radiotherapy, Gustave Roussy University Hospital, Villejuif, France. 5. Department of Neurosurgery, Clairval Private Hospital, Ramsay-Générale de Santé, Marseille, France. 6. Department of Neurosurgery, Sainte-Anne Hospital, Paris, France; Paris Descartes University, Sorbonne Paris Cité, Paris, France; Inserm, U894, IMA-Brain, Centre de Psychiatrie et Neurosciences, Paris, France. Electronic address: j.pallud@ch-sainte-anne.fr.
Abstract
BACKGROUND: There is no consensus concerning the management of adult patients with posterior fossa metastasis-associated obstructive hydrocephalus, especially regarding surgical procedures. A literature review was performed to assess the surgical strategy in the management of patients with metastatic brain tumor. METHODS: A literature search was conducted of PubMed in November 2017 to identify all studies concerning brain metastases and obstructive hydrocephalus in English. All studies (except case reports and pediatric studies) between December 1953 and November 2017 that were about posterior fossa metastasis-associated obstructive hydrocephalus in adult patients were eligible. Eligible studies were classified by level of evidence. We assessed epidemiology, clinical and imaging findings, neurosurgical management, and prognosis of adult patients with posterior fossa metastasis-associated obstructive hydrocephalus. We suggest some practical considerations and a management decision tree on behalf of the Neuro-oncology Club of the French Society of Neurosurgery, with evidence-based analysis. RESULTS: Direct surgical resection could be considered for patients with asymptomatic obstructive hydrocephalus, and endoscopic third ventriculostomy seems to be a reasonable procedure for patients with symptomatic obstructive hydrocephalus. A ventriculoperitoneal or atrial shunt seems to be a valid alternative when patients have a history of central nervous system infection or ventricular hemorrhage, leptomeningeal carcinomatosis, or unfavorable anatomy for an endoscopic third ventriculostomy to be performed. CONCLUSIONS: The Neuro-oncology Club of the French Society of Neurosurgery suggests a prospective assessment of these neurosurgical procedures to compare their safety and efficacy.
BACKGROUND: There is no consensus concerning the management of adult patients with posterior fossa metastasis-associated obstructive hydrocephalus, especially regarding surgical procedures. A literature review was performed to assess the surgical strategy in the management of patients with metastatic brain tumor. METHODS: A literature search was conducted of PubMed in November 2017 to identify all studies concerning brain metastases and obstructive hydrocephalus in English. All studies (except case reports and pediatric studies) between December 1953 and November 2017 that were about posterior fossa metastasis-associated obstructive hydrocephalus in adult patients were eligible. Eligible studies were classified by level of evidence. We assessed epidemiology, clinical and imaging findings, neurosurgical management, and prognosis of adult patients with posterior fossa metastasis-associated obstructive hydrocephalus. We suggest some practical considerations and a management decision tree on behalf of the Neuro-oncology Club of the French Society of Neurosurgery, with evidence-based analysis. RESULTS: Direct surgical resection could be considered for patients with asymptomatic obstructive hydrocephalus, and endoscopic third ventriculostomy seems to be a reasonable procedure for patients with symptomatic obstructive hydrocephalus. A ventriculoperitoneal or atrial shunt seems to be a valid alternative when patients have a history of central nervous system infection or ventricular hemorrhage, leptomeningeal carcinomatosis, or unfavorable anatomy for an endoscopic third ventriculostomy to be performed. CONCLUSIONS: The Neuro-oncology Club of the French Society of Neurosurgery suggests a prospective assessment of these neurosurgical procedures to compare their safety and efficacy.
Authors: Muriel Heimann; Niklas Schäfer; Christian Bode; Valeri Borger; Lars Eichhorn; Frank A Giordano; Erdem Güresir; Andreas H Jacobs; Yon-Dschun Ko; Jennifer Landsberg; Felix Lehmann; Alexander Radbruch; Christina Schaub; Katjana S Schwab; Johannes Weller; Ulrich Herrlinger; Hartmut Vatter; Patrick Schuss; Matthias Schneider Journal: Front Oncol Date: 2021-07-26 Impact factor: 6.244