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Updated: Jun 24, 2026
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Palliative ventriculoperitoneal shunt in a pediatric patient with recurrent metastatic medulloblastoma
Deborah Schiff1, Cassie Kline, Hal Meltzer
1Department of Hematology/Oncology, Rady Children's Hospital-San Diego, San Diego, California 92123, USA. dschiff@chsd.org
Insights
A ventriculoperitoneal (VP) shunt improved a child's recurrent metastatic medulloblastoma. Palliative shunting can manage hydrocephalus and intracranial hypertension in leptomeningeal spread, potentially improving quality of life.
Area of Science:
- Pediatric Oncology
- Neurosurgery
- Palliative Care
Background:
- Medulloblastoma is a common pediatric brain tumor.
- Leptomeningeal (LM) spread of malignancy can cause hydrocephalus and intracranial hypertension (ICH).
- Palliative surgical management is considered for symptom control in advanced disease.
Observation:
- A pediatric patient with recurrent metastatic medulloblastoma developed hydrocephalus.
- The patient received a palliative ventriculoperitoneal (VP) shunt.
- Significant clinical improvement was observed post-operatively.
Findings:
- VP shunting can be an effective palliative intervention for hydrocephalus and ICH in pediatric patients with LM spread.
- Literature supports the use of shunting for managing symptoms of increased intracranial pressure in leptomeningeal malignancy.
- While prognosis remains poor, VP shunting may offer quality of life benefits.
Implications:
- Palliative VP shunting should be considered in select pediatric patients with recurrent metastatic medulloblastoma and LM spread.
- Careful consideration of risks and benefits is crucial for invasive procedures in end-of-life care.
- This approach may improve neurological symptoms and overall well-being in patients with limited treatment options.
Abstract:
The authors present a case report of a pediatric patient with recurrent metastatic medulloblastoma who demonstrated significant clinical improvement after placement of a palliative ventriculoperitoneal (VP) shunt. They also review the medical literature that supports palliative surgical management of hydrocephalus and intracranial hypertension (ICH) caused by leptomeningeal (LM) spread of malignancy. The burdens and benefits of an invasive surgical procedure must always be weighed carefully, especially at end-of-life. Yet for some patients with LM spread and ICH, VP shunting may improve their quality of life, although their prognosis remains poor.
