EVOLUTION OF THE MANAGEMENT OF HYDROCEPHALUS ASSOCIATED WITH ACOUSTICNEUROMA

The management of hydrocephalus in association with a cerebellopontine angle tumor is controversial. There is a widely held belief that init ial therapy should always be directed toward treatment of hydrocephalu s before definitive surgery, The potential problems of cerebrospinal f luid (CSF) shunting and drainage have led to an evolution in the manag ement of hydrocephalus at St, Vincent's Hospital, There is growing evi dence that complete removal of cerebellopontine angle tumors will resu lt in resolution of hydrocephalus without requiring other methods of C SF decompression. The authors present their experience of 14 patients with hydrocephalus found in a recent series of 104 consecutive cases o f acoustic neuroma, This study has detected a significant correlation between hydrocephalus and increasing tumor size (P=,0234). The mean tu mor size in this series was 3.8 cm, The series has also demonstrated t hat successful, safe, and complete tumor removal can be achieved witho ut CSF drainage before surgery.