HYDROCEPHALUS IN CEREBELLOPONTINE ANGLE TUMORS: EVALUATING THE ROLE OF VENTRICULOPERITONEAL SHUNTS

Abstract

Background: Hydrocephalus is a frequent and serious complication of cerebellopontine angle (CPA) tumors due to cerebrospinal fluid (CSF) flow obstruction. Ventriculoperitoneal (VP) shunting is commonly used to relieve intracranial pressure, but comprehensive outcome evaluations, including neurological and quality-of-life (QoL) parameters, remain limited. Objective: To evaluate the efficacy of ventriculoperitoneal shunting in managing hydrocephalus associated with CPA tumors, focusing on intracranial pressure (ICP), neurological status, and quality of life. Study Design: Prospective observational study. Setting: Department of Neurosurgery, Lady Reading Hospital, Peshawar, Pakistan. Duration of Study: Four years, from January 2020 to December 2023. Methods: A total of 190 patients diagnosed with hydrocephalus secondary to CPA tumors were included. All patients underwent ventriculoperitoneal shunt placement. Clinical outcomes were assessed using intracranial pressure (ICP) measurements, Glasgow Coma Scale (GCS) scores, and the Short Form-36 (SF-36) quality of life survey. Data were recorded preoperatively and at 1, 3, and 6 months postoperatively. Statistical analysis was performed using SPSS version 25.0. Paired t-tests were used to evaluate pre- and postoperative differences, with p < 0.05 considered statistically significant. Results: The mean age of patients was 45.3 ± 12.4 years. Males constituted 55.3% and females 44.7% of the study population. Following VP shunting, a significant reduction in mean ICP was observed from 25.4 ± 5.1 mmHg to 12.7 ± 3.8 mmHg (p < 0.001). Mean GCS scores improved from 9.2 ± 3.5 preoperatively to 13.6 ± 2.1 postoperatively (p < 0.001). SF-36 QoL scores increased markedly from 40.5 ± 15.3 to 75.2 ± 10.7 (p < 0.001). Additionally, hospital readmission rates declined from 20% preoperatively to 5% postoperatively (p < 0.01). Conclusion: Ventriculoperitoneal shunting is an effective intervention for managing hydrocephalus in patients with CPA tumors, significantly reducing intracranial pressure and improving neurological function and quality of life.