Large vestibular schwannomas and hydrocephalus: Lessons learnt from a single centre experience
Aim The aim of the following study is to analyze the outcome following surgery in 169 patients with large vestibular schwannoma (VS) and to evaluate hydrocephalus as a prognostic factor in patients of the VSs. Subjects and Methods Retrospective analysis of all cases of VSs admitted to ou...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Thieme Medical Publishers, Inc.
2014-01-01
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| Series: | Indian Journal of Neurosurgery |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.4103/2277-9167.131997 |
| _version_ | 1819133048787042304 |
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| author | Prakash Nair Devesh Kumar Singh Rabi Narayan Sahu Raj Kumar Sanjay Behari Awadesh Kumar Jaiswal Arun Kumar Srivastava |
| author_facet | Prakash Nair Devesh Kumar Singh Rabi Narayan Sahu Raj Kumar Sanjay Behari Awadesh Kumar Jaiswal Arun Kumar Srivastava |
| author_sort | Prakash Nair |
| collection | DOAJ |
| description | Aim
The aim of the following study is to analyze the outcome following surgery in 169 patients with large vestibular schwannoma (VS) and to evaluate hydrocephalus as a prognostic factor in patients of the VSs.
Subjects and Methods
Retrospective analysis of all cases of VSs admitted to our tertiary neurosurgical center from January 2005 to December 2010 was performed. Comparison of patients who underwent pre-operative cerebrospinal fluid (CSF) diversion and those who underwent primary surgery was carried out for post-operative complications and delayed hydrocephalus.
Results
A total of 169 patients of VS were seen. The mean age at presentation was 39.03 years (12-72 years). The most common symptom was hearing loss seen in 161 (95.2%) cases. Giant VS was seen in 130 (75.5%) and hydrocephalus was present in 110 (63.9%). Pre-operative CSF diversion was done in 23 (13.1%) patients; 8 (4.6%) patients developed gradually symptomatic hydrocephalus following surgery and underwent ventriculoperitoneal shunt. Total surgical excision was done in 92.9% patients and subtotal excision was done in 7% patients.
Conclusions
Hydrocephalus occurs in longstanding untreated cases of VS. Hydrocephalus causes no statistically significant increase in post-operative complications like CSF leak and post-operative hematoma. Patients with hydrocephalus presenting with acute symptoms of raised intracranial pressure benefit from CSF diversion. In most patients, tumor resection will restore patency of the CSF pathway and CSF diversion can be avoided. |
| first_indexed | 2024-12-22T09:41:06Z |
| format | Article |
| id | doaj.art-042857be5e1544c68b7cc255b39eac2f |
| institution | Directory Open Access Journal |
| issn | 2277-954X 2277-9167 |
| language | English |
| last_indexed | 2024-12-22T09:41:06Z |
| publishDate | 2014-01-01 |
| publisher | Thieme Medical Publishers, Inc. |
| record_format | Article |
| series | Indian Journal of Neurosurgery |
| spelling | doaj.art-042857be5e1544c68b7cc255b39eac2f2022-12-21T18:30:41ZengThieme Medical Publishers, Inc.Indian Journal of Neurosurgery2277-954X2277-91672014-01-01030101902410.4103/2277-9167.131997Large vestibular schwannomas and hydrocephalus: Lessons learnt from a single centre experiencePrakash NairDevesh Kumar Singh0Rabi Narayan Sahu1Raj Kumar2Sanjay Behari3Awadesh Kumar Jaiswal4Arun Kumar SrivastavaSanjay Gandhi Postgraduate Institute of Medical SciencesSanjay Gandhi Postgraduate Institute of Medical SciencesDirector, All India Institute of Medical SciencesSanjay Gandhi Postgraduate Institute of Medical SciencesSanjay Gandhi Postgraduate Institute of Medical SciencesAim The aim of the following study is to analyze the outcome following surgery in 169 patients with large vestibular schwannoma (VS) and to evaluate hydrocephalus as a prognostic factor in patients of the VSs. Subjects and Methods Retrospective analysis of all cases of VSs admitted to our tertiary neurosurgical center from January 2005 to December 2010 was performed. Comparison of patients who underwent pre-operative cerebrospinal fluid (CSF) diversion and those who underwent primary surgery was carried out for post-operative complications and delayed hydrocephalus. Results A total of 169 patients of VS were seen. The mean age at presentation was 39.03 years (12-72 years). The most common symptom was hearing loss seen in 161 (95.2%) cases. Giant VS was seen in 130 (75.5%) and hydrocephalus was present in 110 (63.9%). Pre-operative CSF diversion was done in 23 (13.1%) patients; 8 (4.6%) patients developed gradually symptomatic hydrocephalus following surgery and underwent ventriculoperitoneal shunt. Total surgical excision was done in 92.9% patients and subtotal excision was done in 7% patients. Conclusions Hydrocephalus occurs in longstanding untreated cases of VS. Hydrocephalus causes no statistically significant increase in post-operative complications like CSF leak and post-operative hematoma. Patients with hydrocephalus presenting with acute symptoms of raised intracranial pressure benefit from CSF diversion. In most patients, tumor resection will restore patency of the CSF pathway and CSF diversion can be avoided.http://www.thieme-connect.de/DOI/DOI?10.4103/2277-9167.131997hydrocephalusretromastoid craniectomyventriculoperitoneal shuntvestibular schwannoma |
| spellingShingle | Prakash Nair Devesh Kumar Singh Rabi Narayan Sahu Raj Kumar Sanjay Behari Awadesh Kumar Jaiswal Arun Kumar Srivastava Large vestibular schwannomas and hydrocephalus: Lessons learnt from a single centre experience Indian Journal of Neurosurgery hydrocephalus retromastoid craniectomy ventriculoperitoneal shunt vestibular schwannoma |
| title | Large vestibular schwannomas and hydrocephalus: Lessons learnt from a single centre experience |
| title_full | Large vestibular schwannomas and hydrocephalus: Lessons learnt from a single centre experience |
| title_fullStr | Large vestibular schwannomas and hydrocephalus: Lessons learnt from a single centre experience |
| title_full_unstemmed | Large vestibular schwannomas and hydrocephalus: Lessons learnt from a single centre experience |
| title_short | Large vestibular schwannomas and hydrocephalus: Lessons learnt from a single centre experience |
| title_sort | large vestibular schwannomas and hydrocephalus lessons learnt from a single centre experience |
| topic | hydrocephalus retromastoid craniectomy ventriculoperitoneal shunt vestibular schwannoma |
| url | http://www.thieme-connect.de/DOI/DOI?10.4103/2277-9167.131997 |
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