Management of hydrocephalus after cerebellar pilocytic astrocytoma in a pediatric patient: case report and literature review Case report

Abstract

Background: Pilocytic astrocytoma (PA) is the most common brain malignancy in children. PA is a distinct histological and biological subgroup of gliomas that have a slow growth rate. Most PAs are located infratentorial and in the median cerebral structures such as the optic nerve, brain stem, and hypothalamus. Hydrocephalus is a common finding in patients with PA.
Case presentation: In this report, we describe a case of a patient treated surgically for PA who developed a common complication – hydrocephalus. Pre-operative dilatation of the lateral ventricles with transependymal cerebrospinal fluid flow along with her young age were defined as the risk factors. She required numerous interventions and the findings along with treatment modalities are discussed in detail.
Conclusions: Cases with pre-existing risk factors for post-operative hydrocephalus should be evaluated prophylactic cerebrospinal fluid diversion surgery. If a more conservative approach is employed, the patients’ neurological status and ventricle size should be closely monitored. Pediatric patients are negatively affected with repetitive surgeries in terms of physical and mental health. Thus, in order to avoid additional interventions, pre-operative planning of all available options should be discussed with the family.