Table 2.
Surgical, radiographic and clinical outcome variables of n = 52 patients patients recieving supratentorial cerebrospinal fluid diversion using image-guided trigonal ventriculostomy during retrosigmoid craniotomy for cerebellopontine angle tumors.
| Surgical outcomes | Total (n = 52, 100%) |
|---|---|
| Single attempt for successful ventriculostomy | 49 (94%) |
| Two attempts for successful ventriculostomy | 3 (6%) |
| Successful CSF-diversion and pulsatile dura prior durotomy without signs of cerebellar contusion, swelling or herniation through the dural incision | 51 (98%) |
| Postoperative hydrocephalus | |
| Due to impaired resorption | 4 (8%) |
| Due to 4th ventricle compression | 6 (11%) |
| Due to upward transtentorial herniation | 2 (4%) |
| Permanent CSF-diversion after surgery | 5 (11%) |
| Days to shunting [mean, (min-max), median] | 91, [3–246], 30 |
| Radiographic outcomes | |
| Catheter tip location and grade | |
| Grade 1: Ipsilateral trigonum, occipital horn or lateral ventricle | 35 (67%) |
| Grade 2: Contralateral trigonum, occipital horn or lateral ventricle / interhemispheric fissure | 15 (28%) |
| Grade 3: Intraparenchymal or basal ganglia | 2 (4%) |
| Supratentorial hemorrhagic complications | |
| Ventriculostomy-related hemorrhage | 6 (11%) |
| Intracerebral hemorrhage | 2 (4%) |
| Intraventricular hemorrhage | 2 (4%) |
| Midline shift | 1 (2%) |
| Ventriculostomy-related revision surgery | 0 (0%) |
| Parenchymal lesion in magnetic resonance imaging | |
| One visible catheter tract | 41 (79%) |
| Two visible catheter tracts | 3 (6%) |
| No visible ventriculostomy tract | 8 (15%) |
| Cortical scarring related to ventriculostomy | 15 (29%) |
| Signs of local infarction | 1 (2%) |
| PCA/SCA infarction | 0 (0%) |
| Radiological signs of upward trans-tentorial herniation | 0 (0%) |
| Clinical outcomes | |
| Seizures related to supratentorial ventriculostomy-related hemorrhage | 0 (0%) |
| Ventriculostomy-related homonymous hemianopsia | 0 (0%) |
| Ventriculostomy-related focal neurological deficit | 0 (0%) |
| Ventriculostomy-related infection | 0 (0%) |
MRI, magnetic resonance imaging; CSF, cerebrospinal fluid; PCA, posterior cerebral artery; SCA, superior cerebellar artery.