[Management of hydrocephalus in the case with pineal region tumor]

When patients have a pineal region tumor, they frequently present with hydrocephalus. However, not all of patients with pineal region tumor continue to suffer from hydrocephalus after tumor therapy. We have retrospectively studied 24 patients, and found that 20 patients (83.3%) have hydrocephalus, and 5 patients (20.8% of all cases and 25.0% of hydrocephalic cases) still have a shunt. We confirmed how fast germinoma diminished under radiation therapy. Irradiation dosage ranged between 30 and 65.8 Gy. Using 10 Gy, germinoma volume decreased to 20.2% of pre-irradiation size. Furthermore, 6 patients who did not receive surgical management for hydrocephalus before radiotherapy did not require a shunt subsequently. Therefore, we concluded that most of pineal germinoma cases do not need surgical management for hydrocephalus, except in those cases where there is pineal apoplexy and aqueductal dissemination.