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Updated: Oct 5, 2026

Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
14:59

Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus

Published on: October 14, 2022

Ascites following ventriculoperitoneal shunting in children with chiasmatic-hypothalamic glioma

Z Gil1, L Beni-Adani, V Siomin

  • 1Division of Pediatric Neurosurgery, Dana Children's Hospital, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Israel.

Child'S Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery
|July 24, 2001
PubMed

Insights

Children with optic pathway gliomas involving the optic nerve or chiasm face a high risk of developing ascites after ventriculoperitoneal shunt placement. Ventriculoatrial shunts may be the preferred treatment for cerebrospinal fluid diversion in these cases.

Area of Science:

  • Pediatric neuro-oncology
  • Neurosurgery
  • Pediatric Gastroenterology

Background:

  • Optic pathway gliomas (OPGs) in children can affect the optic nerve, chiasm, and hypothalamus, potentially leading to hydrocephalus.
  • Hydrocephalus often necessitates ventriculoperitoneal (VP) shunt placement for cerebrospinal fluid (CSF) diversion.
  • CSF ascites is a rare but significant complication of VP shunts.

Purpose of the Study:

  • To identify risk factors for developing CSF ascites in pediatric patients with OPGs.
  • To evaluate the association between tumor location and the incidence of ascites post-VP shunt placement.

Main Methods:

  • Retrospective analysis of 22 children (4 months to 20 years) with chiasmatic-hypothalamic OPGs.
  • Assessment of hydrocephalus, VP shunt placement, and subsequent development of CSF ascites.
  • Correlation of ascites incidence with tumor characteristics, infection, metastasis, and shunt revisions.

Main Results:

  • Twelve children (55%) required VP shunt placement for hydrocephalus.
  • Four of the 12 shunted children (33%) developed CSF ascites.
  • Ascites was significantly associated with gliomas involving the optic chiasm or nerve (4/7, 57% risk), but not with pure hypothalamic gliomas.

Conclusions:

  • Glioma involving the optic chiasm or nerve is a significant risk factor for developing ascites after VP shunt placement in children.
  • Ventriculoatrial (VA) shunt placement may be the preferred management strategy for CSF diversion in these high-risk patients to prevent or treat ascites.
Abstract

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