Experience In Diagnosis And Treatment Of Perioperative Hydrocephalus In Children With Posterior Third Ventricle Lesions

Objective:To summarize the clinical characteristics,diagnosis and treatment of hydrocephalus in children with posterior third ventricle lesions during perioperative period.Methods:The clinical data of 47 children with posterior lesions of the third ventricle treated in the second Hospital of Hebei Medical University fro m May 2014 to May 2019 were analyzed retrospectively,and the experience of diagnosis and treatment of perioperative hydrocephalus was summarized with literature review.Results: 1.Among the 47 cases,the incidence of perioperative hydrocephalus was 85%(40 cases),including 18 cases of benign and lowgrade malignant lesions,11 cases of surgical resection,6 cases of palliative treatment,1 case of radiotherapy,2 cases of postoperative high intracranial pressure and persistent hydrocephalus.2 cases of cerebral hernia after palliative treatment,the rest of the children were stable.Among the 22 cases of highly malignant lesions,surgical resection was performed in 15 cases,radiotherapy and chemotherapy in 7 cases,postoperative coma in 2 cases and no response to radiotherapy and chemotherapy in 1 case.2.Among the 40 cases with hydrocephalus,26 cases were treated with surgical resection,9 cases with preoperative hydrocephalus,21 cases with intraoperative hydrocephalus,18 cases with no persistent hydrocephalus after operation,19 cases with postoperative hydrocephalus,4cases of persistent hydrocephalus with high intracranial pressure were treated with VPS,and 16 cases were discharged smoothly.Conclusions:The treatment of perioperative hydrocephalus of different types of lesions varies with the treatment of the diseases.the treatment of hydrocephalus at different times should consider the clinical standard and imaging evaluation at the same time,strictly grasp the surgical indications and choose the best personalized treatment.