Abstract Introduction: Hydrocephalus in association of posterior cranial fossa tumors (PFT)
remains a matter of controversy; whether to perform cerebrospinal fluid (CSF) diversion prior to
tumor resection, or to perform direct tumor resection.
Objective: The aim of this study is to assess the risks and benefits associated with routine intraoperative
insertion of external ventricular drainage (EVD) catheters in patients with PFT presenting
with hydrocephalus.
Methods: Forty two patients with PFT with secondary hydrocephalus had intraoperative insertion
of an external ventricular drainage catheter, it was kept closed, unless intraoperative lowering of the
intracranial tension was needed, or opened postoperatively in cases of persistent hydrocephalus,
CSF leak, in certain cases throughout and after the procedure.
Results: Eight cases (19%) needed opening of the drainage system during surgery to lower the
intracranial tension. In the postoperative period, twelve cases (28.5%) needed opening of the
EVD for the persistence of hydrocephalus, occurrence of CSF leak or bloody CSF. Only eight cases
(19%) needed permanent CSF shunting, seven of which were ependymomas and medulloblastomas.
None of the cases in this series acquired any EVD related infection, nor did those who required
subsequent permanent CSF diversion.