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Vol. 2. Issue 5.
Pages 240-241 (September - October 2017)
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Vol. 2. Issue 5.
Pages 240-241 (September - October 2017)
PS210
Open Access
Evaluation of clinical characteristics as indicators for shunt procedure in patients with medulloblastoma
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A. Paunović
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aleksandra.paunovic92@gmail.com

Corresponding author.
, F. Milisavljević, J. Bošković
School of Medicine, University of Belgrade, Serbia
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Aim: Determing clinical characteristics and parameters reliable as predictors of the need for the shunt installation and their relation to the treatment outcome.

Introduction: Medulloblastoma represents the most common pediatric tumor, that most frequently involves posterior cranial fossa and often manifests as hydrocephalus. Current therapy involves tumor excision and posterior cranial fossa decompression, with or without temporary external drainage of cerebrospinal fluid, endoscopic ventriculocisternostomy and ventriculoperitoneal (VP) shunt placement.

Methods: This retrospective study included 36 patients treated in the period from January 1st 2007 to December 31st 2015 in the Clinic of Neurosurgery, Clinical Center of Serbia. Basic demographic data, symptoms and signs at admission, degree of tumor resection and disease outcome information were analyzed.

Results: 22 patients (61.1%) were male and 14 (38.9%) were female, most of them 4–14 years old (58.3). Sex and age showed no significant corelation with VP shunt installation, or timing of shunt installation. VP shunt was installed in 92% of patients, in 33.3% prior to and in remaining after surgery. The most frequently observed symptoms on admission were cerebellar symptomatology (91.2%), headache (75.7%) and vomiting (68.5%), which showed no significant correlation with the VP shunt installation and shunt installation timing. In 83% of patients total resection was achieved. The degree of tumor resectability and VP shunt installation were significantly related (p<0.001). Correlation among shunt installation and treatment outcomes, as well as the shunt installation timing and outcome showed a statistical significance (p<0.001).

Conclusion: No clinical characteristics reliable as prognostic parameter for VP shunt installation in medulloblastoma patients have been found. Shunt placement is recommended in all cases of incomplete tumor resection, unless already placed preoperatively. Patients with a shunt placed prior to surgery have had significantly better outcome.1–35

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