Hydrocephalus Associated with Brain Tumor: Characteristics, Management & Outcomes in a Regional Neurosurgical Centre in Nigeria

Abstract
Introduction: Brain tumor is a common neurosurgical condition encountered by neurosurgeons in clinical practice. Hydrocephalus could be associated with brain tumor thereby increasing the burden of the disease to the affected patients. Characteristics and outcome of hydrocephalus resulting from brain tumors are almost unknown in our setting. The objectives of this study were to describe the characteristics and outcome of hydrocephalus caused by brain tumor in our center. Methods: A retrospective analysis of all cases of hydrocephalus resulting from brain tumor managed in our center between January 2015 to December 2019. Relevant data extracted from patient’s case files and operation register was analysed. Results: Out of the total sixty-eight cases of brain tumors, thirty (44.1%) cases of hydrocephalus caused by brain tumor were managed over the study period. The mean age of presentation was 14 years ± 2 SD with a slight male preponderance (M: F = 1.07:1). The most common clinical presentations were headache, progressive visual impairment, altered conscious level and ataxia. Posterior fossa tumors were the commonest (21/30), followed by craniopharyngioma (6/30) and one case each for pituitary macroadenoma, pineal region tumor and choroid plexus papilloma respectively. Pediatric age group was the most affected (19/30). All patients had ventriculoperitoneal shunting before definitive surgery. Postoperative outcome was good in the majority of cases (27/30), mortality was recorded in one patient (1/30). Conclusion: Hydrocephalus is a common association in patients with brain tumor in our center. Most cases of brain tumor associated hydrocephalus occur in children and posterior fossa tumor is the commonest aetiology. The outcome of ventriculoperitoneal shunting is relatively good in our setting.