{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T02:44:47Z","timestamp":1783651487601,"version":"3.55.0"},"reference-count":17,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>The clinical course of high-grade central nervous system gliomas is occasionally complicated by hydrocephalus. The risks of shunt placement and clinical outcome following CSF diversion in this population are not well defined.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>The authors retrospectively reviewed the outcomes of patients with pathologically confirmed WHO grade III or IV gliomas with shunt-treated hydrocephalus at their institution. Outcomes of patients in this cohort were compared with those of patients who underwent shunt treatment for normal pressure hydrocephalus (NPH). Hospital-reported outcomes in a national database for malignant primary brain tumor patients undergoing a ventricular shunt procedure were also reviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Forty-one patients undergoing CSF shunting between 2001 and 2016 at the authors\u2019 institution were identified. Noncommunicating and communicating hydrocephalus occurred at similar rates (51.2% vs 48.8%). Symptomatic improvement after shunting was observed in 75.0% of patients. A major complication occurred in 17.1% of cases, with 2 patients suffering an intracranial hemorrhage. Prior administration of bevacizumab was significantly associated with the incidence of hemorrhage (p = 0.026). Three patients (7.3%) died during admission, and 8 (19.5%) died within 30 days of shunt placement. The presence of ependymal or leptomeningeal enhancement was more common in patients who died within 30 days (75.0% vs 11.1%, p = 0.001). Six patients (18.1%) required readmission to the hospital within 30 days of discharge. Revision surgery was necessary in 7 patients (17.1%). The median time from shunt placement to death was 150.5 days. In comparison with patients with NPH, shunt-treated high-grade glioma patients had increased in-hospital (7.3% vs 0.5%, p = 0.008) and 30-day (19.5% vs 0.8%, p &lt; 0.001) mortality but no difference in the incidence of revision surgery (17.1% vs 17.5%, p = 0.947). Similarly, in the national Vizient Clinical Database Resource Manager, shunt-treated patients with malignant primary brain tumors had an increased length of stay (6.9 vs 3.5 days, p &lt; 0.001), direct cost of admission ($15,755.80 vs $9871.50, p &lt; 0.001), and 30-day readmission rates (20.6% vs 2.4%, p &lt; 0.001) compared with patients without brain tumors who received a shunt for NPH.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Shunting can be an effective treatment for the symptoms of hydrocephalus in patients with high-grade gliomas. However, the authors\u2019 results suggest that this procedure carries a significant risk of complications in this patient population.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2017.6.jns17859","type":"journal-article","created":{"date-parts":[[2017,12,22]],"date-time":"2017-12-22T15:01:37Z","timestamp":1513954897000},"page":"984-996","source":"Crossref","is-referenced-by-count":15,"title":["Outcomes following cerebrospinal fluid shunting in high-grade glioma patients"],"prefix":"10.3171","volume":"129","author":[{"given":"Lorenzo","family":"Rinaldo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Desmond","family":"Brown","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Lanzino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian F.","family":"Parney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1227\/NEU.0000000000001263","article-title":"Ventriculoperitoneal shunting for glioblastoma: risk factors, indications, and efficacy","volume":"80","author":"Castro BA","year":"2017","unstructured":"Castro BA, Imber BS, Chen R, McDermott MW, Aghi MK: Ventriculoperitoneal shunting for glioblastoma: risk factors, indications, and efficacy. 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