VALUE OF PRECRANIOTOMY SHUNTS IN CHILDREN WITH POSTERIOR-FOSSA TUMORS

Seventy children with posterior fossa tumours treated over a period of 6 1/2 years were studied. Most patients presented in the late stage o f disease. Sixty-four required insertion of a precraniotomy shunt for one or more of the following: persistent vomiting, severe headache, de hydration, poor general condition, failing vision, altered sensorium, marked periventricular lucency, and brain stem involvement deferring t otal removal of the tumour. Insertion of precraniotomy shunt improved the general condition and signs and symptoms of increased intracranial pressure. It also provided a lax brain during definitive surgery and a smooth postoperative course. Shunt-related complications, consisting of block and/or infection, were observed in 21 patients. It was concl uded that precraniotomy shunt is important in the management of childr en with posterior fossa tumours in developing countries where these pa tients present in the late stage of disease.