Document Detail

The value of ventriculo-peritoneal shunting in patients with glioblastoma multiforme and ventriculomegaly.
MedLine Citation:
PMID:  18180865     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Patients with an advanced-stage glioblastoma multiforme (GBM) often show general motor, gait, and cognitive deterioration. Some have radiological evidence of ventriculomegaly, but the relevance of this to their symptoms may be unclear. Distinction between tumour patients who have dilated fluid spaces as a consequence of tissue loss from surgery or treatment, and those who have a symptomatic hydrocephalic process, one who may gain benefit from insertion of a ventriculo-peritoneal shunt, is an important clinical challenge. METHODS: From a series of 530 GBM patients treated by a single surgeon (ZR), we retrospectively reviewed 16 patients with advanced-stage GBM who had presented with non-obstructive ventriculomegaly and clinical deterioration not explained by progressive disease. Each had been treated by insertion of a ventriculo- peritoneal shunt (VPS). Assessments included clinical features, Karnofsky Performance Scale, motor and cognitive findings, complications and survival. FINDINGS: Ten patients benefited from insertion of the shunt, with moderate to significant cognitive improvement. Of seven patients who presented with motor symptoms, such as gait instability, general weakness, and slowness, four patients showed significant motor improvement in addition to major cognitive improvement. Early infectious complication occurred in five patients; a late shunt infection in one; one patient had symptoms related to overdrainage; and in another a mechanical shunt malfunction occurred. Three patients died from shunt-related complications. CONCLUSIONS: Insertion of a ventriculo-peritoneal shunt can improve cognitive and motor function in a small subset of patients with advanced-stage glioblastoma multiforme and ventriculomegaly. Infection is a major risk in this patient population.
J Roth; S Constantini; D T Blumenthal; Z Ram
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Publication Detail:
Type:  Journal Article     Date:  2008-01-10
Journal Detail:
Title:  Acta neurochirurgica     Volume:  150     ISSN:  0942-0940     ISO Abbreviation:  Acta Neurochir (Wien)     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-01-24     Completed Date:  2008-03-12     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0151000     Medline TA:  Acta Neurochir (Wien)     Country:  Austria    
Other Details:
Languages:  eng     Pagination:  41-6; discussion 46-7     Citation Subset:  IM    
Tel-Aviv Medical Center, Department of Neurosurgery, Tel-Aviv, Israel.
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MeSH Terms
Follow-Up Studies
Glioblastoma / surgery*
Middle Aged
Prosthesis-Related Infections / etiology
Retrospective Studies
Treatment Outcome
Ventriculoperitoneal Shunt / adverse effects,  methods*

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