{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T18:11:10Z","timestamp":1774635070196,"version":"3.50.1"},"reference-count":22,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Pediatric patients are at risk of persistent hydrocephalus after posterior fossa tumor resection. The relationship between surgery-related factors and postoperative symptomatic hydrocephalus has not been elucidated. The objective of this study was to analyze features influencing postoperative hydrocephalus in Chinese children.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The authors retrospectively evaluated 197 patients younger than 15 years of age who underwent posterior fossa tumor resection at their institution from January 2015 to June 2021. The outcome was whether children underwent CSF diversion within 6 months of resection. Preoperative characteristics, surgery-related factors, and postoperative features were included to identify independent prognosticators. A new logistic model containing independent prognosticators was developed and compared with the modified Canadian Preoperative Prediction Rule for Hydrocephalus (mCPPRH).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>In this study, 30 patients (15.2%) underwent CSF diversion within 6 months after tumor resection. Tumor location and consistency, intracranial or spinal tumor metastasis determined by perioperative cerebral and spinal MRI, intraoperative blood loss, ventricular blood as determined on postoperative CT, and pathology were statistically significant variables in the univariate analysis. The only two independent predictors of postoperative symptomatic hydrocephalus were tumor metastasis (OR 3.463, 95% CI 1.137\u201310.549; p = 0.029) and postoperative ventricular blood (OR 4.212, 95% CI 1.595\u201311.122; p = 0.004). The final logistic model comprising tumor metastasis and postoperative ventricular blood was found to have better discrimination than the mCPPRH.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Tumor characteristics and surgery-related features were associated with postoperative symptomatic hydrocephalus. Tumor metastasis and postoperative ventricular blood were found to be important prognosticators of persistent hydrocephalus.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2022.10.peds22281","type":"journal-article","created":{"date-parts":[[2022,11,11]],"date-time":"2022-11-11T14:24:42Z","timestamp":1668176682000},"page":"99-108","source":"Crossref","is-referenced-by-count":13,"title":["Contribution of tumor characteristics and surgery-related factors to symptomatic hydrocephalus after posterior fossa tumor resection: a single-institution experience"],"prefix":"10.3171","volume":"31","author":[{"given":"Nijia","family":"Zhang","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Di","family":"Zhang","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jihang","family":"Sun","sequence":"additional","affiliation":[{"name":"Radiology, Beijing Children\u2019s Hospital, Capital Medical University, National Center for Children\u2019s Health, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hailang","family":"Sun","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming","family":"Ge","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"3","key":"b1","series-title":"Neurol Clin","first-page":"533","article-title":"Pediatric brain tumors","volume":"36","author":"Udaka YT","year":"2018","unstructured":"Udaka YT, Packer RJ. 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Lancet. 2016;387(10020):788\u2013799.26256071"},{"issue":"3 Suppl","key":"b4","series-title":"J Neurosurg","first-page":"247","article-title":"Persistent hydrocephalus after early surgical management of posterior fossa tumors in children: is routine preoperative endoscopic third ventriculostomy justified?","volume":"103","author":"Morelli D","year":"2005","unstructured":"Morelli D, Pirotte B, Lubansu A,  Persistent hydrocephalus after early surgical management of posterior fossa tumors in children: is routine preoperative endoscopic third ventriculostomy justified? J Neurosurg. 2005;103(3 Suppl):247\u2013252.16238078"},{"issue":"5","key":"b5","series-title":"J Neurosurg Pediatr","first-page":"378","article-title":"Predicting postresection hydrocephalus in pediatric patients with posterior fossa tumors","volume":"3","author":"Riva-Cambrin J","year":"2009","unstructured":"Riva-Cambrin J, Detsky AS, Lamberti-Pasculli M,  Predicting postresection hydrocephalus in pediatric patients with posterior fossa tumors. J Neurosurg Pediatr. 2009;3(5):378\u2013385.19409016"},{"issue":"3","key":"b6","series-title":"J Neurosurg Pediatr","first-page":"220","article-title":"Validation and modification of a predictive model of postresection hydrocephalus in pediatric patients with posterior fossa tumors","volume":"12","author":"Foreman P","year":"2013","unstructured":"Foreman P, McClugage S III, Naftel R,  Validation and modification of a predictive model of postresection hydrocephalus in pediatric patients with posterior fossa tumors. J Neurosurg Pediatr. 2013;12(3):220\u2013226.23808727"},{"issue":"5","key":"b7","series-title":"J Neurosurg Pediatr","first-page":"533","article-title":"Ventriculomegaly and postoperative lateral\/third ventricular blood as predictors of cerebrospinal fluid diversion following posterior fossa tumor resection","volume":"28","author":"Park C","year":"2021","unstructured":"Park C, Liu B, Harward SC,  Ventriculomegaly and postoperative lateral\/third ventricular blood as predictors of cerebrospinal fluid diversion following posterior fossa tumor resection. J Neurosurg Pediatr. 2021;28(5):533\u2013543.34388710"},{"issue":"3","key":"b8","series-title":"Eur J Neurol","first-page":"468","article-title":"Estimated ventricle size using Evans index: reference values from a population-based sample","volume":"24","author":"Jaraj D","year":"2017","unstructured":"Jaraj D, Rabiei K, Marlow T, Jensen C, Skoog I, Wikkels\u00f8 C. Estimated ventricle size using Evans index: reference values from a population-based sample. Eur J Neurol. 2017;24(3):468\u2013474.28052454"},{"issue":"5","key":"b9","series-title":"Pediatr Neurosurg","first-page":"245","article-title":"Frontal and occipital horn ratio: a linear estimate of ventricular size for multiple imaging modalities in pediatric hydrocephalus","volume":"29","author":"O\u2019Hayon BB","year":"1998","unstructured":"O\u2019Hayon BB, Drake JM, Ossip MG, Tuli S, Clarke M. Frontal and occipital horn ratio: a linear estimate of ventricular size for multiple imaging modalities in pediatric hydrocephalus. Pediatr Neurosurg. 1998;29(5):245\u2013249.9917541"},{"issue":"3","key":"b10","series-title":"Pediatr Neurosurg","first-page":"205","article-title":"Risk factors of persistent hydrocephalus in children with brain tumor: a retrospective analysis","volume":"56","author":"Pilotto C","year":"2021","unstructured":"Pilotto C, Liguoro I, Scaravetti S,  Risk factors of persistent hydrocephalus in children with brain tumor: a retrospective analysis. Pediatr Neurosurg. 2021;56(3):205\u2013212.33784707"},{"issue":"4","key":"b11","series-title":"Br J Neurosurg","first-page":"451","article-title":"Paediatric posterior fossa tumour resection rates in a small volume centre: the past decade\u2019s experience","volume":"35","author":"Bhatt H","year":"2021","unstructured":"Bhatt H, Bhatti MI, Patel C, Leach P. Paediatric posterior fossa tumour resection rates in a small volume centre: the past decade\u2019s experience. 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