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Risk factors for new-onset shunt-dependency after craniotomies for intracranial tumors in adult patients

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Abstract

The risk of developing a de novo shunt-dependent hydrocephalus (HC) after undergoing a craniotomy for brain tumor in adult patients is largely unknown. All craniotomies for intracranial tumors at Oslo University Hospital in adult patients ≥18 years of age during a 10-year period (2004–2013) were included. None were lost to follow-up. Patients who developed a shunt-dependent HC were identified by cross-linking our prospectively collected tumor database to patients with a NCSP surgical procedure code of hydrocephalus (AAF). Patients with pre-existing HC or ventriculoperitoneal (VP) shunts were excluded from the study. A total of 4401 craniotomies were performed. Of these, 46 patients (1.0%) developed de novo postoperative HC requiring a VP shunt after a median of 93 days (mean 115 days, range 6–442). Median age was 62.0 years (mean 58.9 years, range 27.3–80.9) at time of VP shunt surgery. Patients without pre-existing HC had a 0.2% (n = 8/4401) risk of becoming VP shunt dependent within 30 days and 0.5% (n = 22/4401) within 90 days. Age, sex, tumor location, primary/secondary surgery, and radiotherapy were not associated with VP shunt dependency. Choroid plexus tumors and craniopharyngiomas had increased risk of VP shunt dependency. In this large, contemporary, single-institution consecutive series, the risk of postoperative shunt-dependency after craniotomies for brain tumors without pre-existing HC was very low. This is the largest study with regards to de novo postoperative shunt-dependency after craniotomies for patients with intracranial tumors and can serve as a benchmark for future studies.

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Author notes

  1. Sayied Abdol Mohieb Hosainey and Benjamin Lassen have contributed equally to this work.

Authors and Affiliations

  1. Department of Neurosurgery, St. Olavs Hospital, Trondheim, Norway

    Sayied Abdol Mohieb Hosainey

  2. Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway

    Benjamin Lassen, John K. Hald, Eirik Helseth & Torstein R. Meling

  3. Department of Radiology, Hospital of Southern Norway, Kristiansand, Norway

    Benjamin Lassen

  4. Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway

    John K. Hald

  5. Department of Neurosurgery, Oslo University Hospital, Oslo, Norway

    Eirik Helseth & Torstein R. Meling

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  1. Sayied Abdol Mohieb Hosainey
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  2. Benjamin Lassen
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Correspondence to Sayied Abdol Mohieb Hosainey.

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Ethical approval

The study has been approved by the institutional ethics committee (Personvernombudets tilrådning 2013/14574).

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Hosainey, S.A.M., Lassen, B., Hald, J.K. et al. Risk factors for new-onset shunt-dependency after craniotomies for intracranial tumors in adult patients. Neurosurg Rev 41, 465–472 (2018). https://doi.org/10.1007/s10143-017-0869-1

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  • DOI: https://doi.org/10.1007/s10143-017-0869-1

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