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Updated: Feb 18, 2026
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Symptomatic communicating hydrocephalus in a contemporary cohort of high grade glioma patients
Thomas Beez1, Sven Burgula1, Marcel Kamp1
1a Department of Neurosurgery, Medical Faculty , Heinrich-Heine-University , Düsseldorf , Germany.
Insights
Symptomatic communicating hydrocephalus (HC) affects 3% of high-grade glioma patients, rising to 10.6% if ventricles were opened during prior surgery. Ventriculoperitoneal shunts effectively treat HC with few complications.
Area of Science:
- Neuro-oncology
- Neurosurgery
- Neurology
Background:
- High-grade glioma (HGG) treatments are intensifying, increasing hospitalization due to side effects.
- Symptomatic communicating hydrocephalus (HC) is a potential complication of HGG therapy.
- Understanding HC incidence, risk factors, and treatment in HGG patients is crucial.
Purpose of the Study:
- To investigate the incidence of symptomatic communicating hydrocephalus in a contemporary HGG cohort.
- To identify risk factors associated with developing HC in HGG patients.
- To evaluate the treatment outcomes for HC in this patient group.
Main Methods:
- Retrospective review of 278 eligible high-grade glioma patients.
- Identification of patients with symptomatic communicating hydrocephalus.
- Extraction of demographic, tumor, and treatment variables; statistical analysis including odds ratios (OR) and 95% confidence intervals (CI).
Main Results:
- Symptomatic communicating hydrocephalus (HC) was diagnosed in 8 (3%) of 278 HGG patients.
- In the subgroup with intraoperative ventricular opening (N=66), HC incidence was 10.6% (N=7).
- Intraoperative opening of ventricles significantly increased HC odds (OR=25.03, p=0.0028); lethargy and headache were common symptoms. Treatment with ventriculoperitoneal shunts led to improvement in all but one patient.
Conclusions:
- Symptomatic communicating hydrocephalus occurs in 3% of HGG patients, with a higher incidence (10.6%) in those with prior intraoperative ventricular opening.
- Intraoperative opening of the ventricles is a significant risk factor for developing HC.
- Ventriculoperitoneal shunting is an effective treatment for HC in HGG patients, demonstrating a low complication rate and leading to patient improvement.
Introduction:
High grade glioma (HGG) treatment has seen a paradigm shift with intensified regimes, but hospitalisation burden is partially attributed to side effects of therapy. Symptomatic communicating hydrocephalus (HC) is a potential complication. Aim of this study was to investigate its incidence, risk factors and treatment in a contemporary cohort.
Methods:
We performed a retrospective review of HGG patients. Patients with symptomatic communicating HC were identified and demographic, tumour and treatment variables extracted from hospital notes. Descriptive statistics were performed and odds ratios (OR) with 95% confidence intervals (CI) calculated.
Results:
From a cohort of 278 eligible HGG patients, 8 (3%) were diagnosed with symptomatic communicating HC. In the subgroup of patients with intraoperative opening of the ventricular system during previous surgery (N = 66), hydrocephalus developed in 10.6% of cases (N = 7). Symptoms were lethargy (N = 5), headache (N = 3), confusion (N = 3), gait disturbance (N = 3) and urinary incontinence (N = 1); three patients presented resembling normal pressure hydrocephalus. A higher rate of intraoperative opening of the ventricles was found in the HC group (p = .0002); all other variables were equally distributed. The increased odds for developing HC for patients with intraoperative opening of the ventricles reached statistical significance (OR = 25.0339, 95% CI = 3.0196-207.5449, p = .0028), whereas previous radiotherapy only increased odds by tendency. Hydrocephalic patients were treated with ventriculoperitoneal shunts and all but one patient improved. One patient had a complication attributed to the shunt procedure The median overall survival after shunting was 4 months.
Conclusions:
Symptomatic communicating hydrocephalus occurred in 3% of HGG patients and in 10.6% in the subgroup with previous intraoperative opening of the ventricles. Treatment with a ventriculoperitoneal shunt is effective and has a low complication rate.
