caa a22 4500 463180984 CHVBK 20180406164839.0 cr unu---uuuuu 170326e20070201xx s 000 0 eng 10.1007/s00381-006-0234-0 doi (NATIONALLICENCE)springer-10.1007/s00381-006-0234-0 Cerebrospinal fluid (CSF) leak and pseudomeningocele formation after posterior fossa tumor resection in children: a retrospective analysis [Elektronische Daten] [P. Steinbok, A. Singhal, J. Mills, D. Cochrane, A. Price] Objective: The purpose of this study was to determine the incidence of pseudomeningocele and cerebrospinal fluid (CSF) leak after posterior fossa tumor surgery and to analyze factors that may be associated with these conditions. In particular, we wished to determine if there was evidence to support the hypothesis that the use of tissue glue, dural grafts, or external ventricular drainage (EVD) prevented CSF from leaking outside the closed dura. Materials and methods: A retrospective chart review was carried out of posterior fossa tumor resections at British Columbia's Children's Hospital. Information was collected regarding tumor location, surgical approach, CSF diversion, dural grafting, and use of tissue glue. Multiple univariate analyses and step-wise logistic regression were performed to identify factors associated with pseudomeningocele formation or CSF leak. A pseudomeningocele was said to be present if it was noted in the clinical records or if a fluid collection was present superficial to the craniotomy flap on a postoperative CT or MR scan. Results: Out of 174 posterior fossa operations, 53 pseudomeningoceles with or without CSF leak were identified along with five CSF leaks in the absence of pseudomeningocele (33%). None of the factors examined reached statistical significance, although there was a trend towards higher rates in patients with external CSF drainage (P=0.06631), dural graft usage (p=0.06492), and patients in whom tissue glue was used (p=0.06181). On logistic regression, only tissue glue use and external CSF drainage were associated with increased incidence of pseudomeningocele and/or CSF leak. Conclusion: In this retrospective study, the use of tissue glue, dural grafts, and external ventricular drainage was not associated with a reduced rate of clinically or radiologically diagnosed pseudomeningocele formation or postoperative CSF leak. The results of this study provide a basis for planning a randomized controlled trial to determine the effectiveness of tissue glue and/or dural grafting in preventing these complications. Springer-Verlag, 2006 Pseudomeningocele nationallicence Cerebrospinal fluid leak nationallicence Pediatric brain tumor nationallicence Posterior fossa nationallicence Tissue glue nationallicence Complications nationallicence Steinbok P. Division of Pediatric Neurosurgery, Department of Pediatric Surgery, British Columbia's Children's Hospital (Children's and Women's Health Centre), 4480 Oak Street, #K3-159, V6H 3V4, Vancouver, BC, Canada aut Singhal A. Division of Pediatric Neurosurgery, Department of Pediatric Surgery, British Columbia's Children's Hospital (Children's and Women's Health Centre), 4480 Oak Street, #K3-159, V6H 3V4, Vancouver, BC, Canada aut Mills J. Division of Pediatric Neurosurgery, Department of Pediatric Surgery, British Columbia's Children's Hospital (Children's and Women's Health Centre), 4480 Oak Street, #K3-159, V6H 3V4, Vancouver, BC, Canada aut Cochrane D. Division of Pediatric Neurosurgery, Department of Pediatric Surgery, British Columbia's Children's Hospital (Children's and Women's Health Centre), 4480 Oak Street, #K3-159, V6H 3V4, Vancouver, BC, Canada aut Price A. Division of Pediatric Neurosurgery, Department of Pediatric Surgery, British Columbia's Children's Hospital (Children's and Women's Health Centre), 4480 Oak Street, #K3-159, V6H 3V4, Vancouver, BC, Canada aut Child's Nervous System Springer-Verlag 23/2(2007-02-01), 171-174 0256-7040 23:2<171 2007 23 381 https://doi.org/10.1007/s00381-006-0234-0 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00381-006-0234-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Steinbok P. Division of Pediatric Neurosurgery, Department of Pediatric Surgery, British Columbia's Children's Hospital (Children's and Women's Health Centre), 4480 Oak Street, #K3-159, V6H 3V4, Vancouver, BC, Canada aut NATIONALLICENCE 700 1- Singhal A. Division of Pediatric Neurosurgery, Department of Pediatric Surgery, British Columbia's Children's Hospital (Children's and Women's Health Centre), 4480 Oak Street, #K3-159, V6H 3V4, Vancouver, BC, Canada aut NATIONALLICENCE 700 1- Mills J. Division of Pediatric Neurosurgery, Department of Pediatric Surgery, British Columbia's Children's Hospital (Children's and Women's Health Centre), 4480 Oak Street, #K3-159, V6H 3V4, Vancouver, BC, Canada aut NATIONALLICENCE 700 1- Cochrane D. Division of Pediatric Neurosurgery, Department of Pediatric Surgery, British Columbia's Children's Hospital (Children's and Women's Health Centre), 4480 Oak Street, #K3-159, V6H 3V4, Vancouver, BC, Canada aut NATIONALLICENCE 700 1- Price A. Division of Pediatric Neurosurgery, Department of Pediatric Surgery, British Columbia's Children's Hospital (Children's and Women's Health Centre), 4480 Oak Street, #K3-159, V6H 3V4, Vancouver, BC, Canada aut NATIONALLICENCE 773 0- Child's Nervous System Springer-Verlag 23/2(2007-02-01), 171-174 0256-7040 23:2<171 2007 23 381 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer