Predictors Of Postresection Hydrocephalus After Skull Base And Periventricular Tumor Operation

Purpose To explore the related factors of postresection hydrocephalus after operation of tumors in the skull base and around the ventricleMethod The clinical data of 122 patients with skull base,ventricle and deep brain tumors treated by neurosurgery from August 2017 to June 2019 in the First Affiliated Hospital of Anhui Medical University were analyzed retrospectively.SPSS16.0 Statistical software was used to analyze the risk factors of postoperative secondary hydrocephalus,including age,gender,hypertension,diabetes,preoperative hydrocephalus,tumor location,texture,side,tumor diameter,tumor resection degree,pathology,operation time,postoperative intracranial infection,intracranial hematoma,etc.Chi square test was used for single factor analysis.Factors with statistical significance in single factor analysis were included in multi factor Logistic regression analysis,and the difference was statistically significant(P<0.05)Results Among the 122 patients,9 patients had hydrocephalus,4 patients was happened in 72 hours,2 patients was between 3 days and 2 weeks,and 3 patients was after 2 weeks Six patients received shunt operation in the follow-up treatment,and three patients were in stable condition and under follow-up observation.In this study,the tumors located in the anterior skull base were 35 cases,and 20 cases in the middle skull base,47 cases in the posterior skull base,14 cases in the deep brain,and 6 cases in the ventricles.Among them,there was 1 patient occurred hydrocephalus in the anterior skull,2 cases occurred in the middle skull base,2 cases occurred in the posterior skull base,1 cases occurred the deep brain,and 3 cases occurred in the ventricles.The results of single factor analysis showed that age(x2=6.616,p=0.010)、preoperative hydrocephalus(x2=6.222,p=0.013)、tumor location(x2=17.872,p=0.001)、side(χ2=13.366,p=0.001)、tumor diameter(χ2=4.319,p=0.038)、tumor resection degree(χ2=10.519,p=0.005)、intracranial hematoma(x2=8.457,p=0.004)have statistical significance for postoperative secondary hydrocephalus,and there was no statistical significance of gender(χ2=0.305,p=0.581)、hypertension(χ2=0.005,p=0.945)、diabetes(χ2=0.002,p=0.963)、texture(x2=0.287,p=0.592)、pathology(χ2=0.063,p=0.801)、operation time(x2=1.410,p=0.235)、postoperative intracranial infection(x2=2.540,p=0.111)for postoperative secondary hydrocephalus.The results showed that tumor location(p=0.016,or=0.36,95%Cl 0.08-1.65),tumor diameter(p=0.018,or=4.53,95%Cl:1.95-10.57)were independent risk factors of secondary hydrocephalusConclusion For patients with intracranial tumors more than 3cm in diameter and those with tumors located in the skull base,especially in the ventricles,especially in the ventricles,we should pay attention to the possibility of postoperative hydrocephalus during the pre-operative conversation.On the basis of fully informed consent,we can simultaneously perform endoscopic third vetriculosfomy and other operations during the operation to reduce the possibility of postoperative hydrocephalus,so as to reduce the risk of the second operation.After the operation,we should regularly review CT and follow-up,and the occurrence of hydrocephalus can be effectively prevented by lumbar puncture or drainage of lumbar cistern.