Work

Establishing the indications of cerebrospinal fluid diversion following pediatric primary intracranial tumor resection: a systematic review and meta-analysis

Year: 2026

Type: review

Study designs: Systematic Review, Meta-Analysis

Abstract: Background While cerebrospinal fluid (CSF) diversion procedures following primary intracranial tumors resection are commonly employed, precise indications in pediatric population remain unclear. This study aims to establish evidence-based indicators for CSF diversion in this population. Methods Systematic searches of ScienceDirect, Medline, and Cochrane databases identified longitudinal studies up to April 2024. Analysis compared risk factors for CSF diversion based on preoperative parameters, surgical technique, tumor characteristics, and postoperative parameters. Subgroup analysis considered ethnicity, tumor location, and presenting hydrocephalus. Results Our meta-analysis of 7 cohort studies included 844 children (mean age 7.30 ± 1.05 years) with a mean tumor volume of 27.90 ± 14.56 cm 3 . Preoperative hydrocephalus (OR 2.91, 95% CI 1.46–5.82, p < 0.001) and periventricular lucency (PVL) (OR 3.60, 95% CI 1.64–7.92, p < 0.001) were strongly associated with CSF diversion, as were medulloblastoma (OR 2.36, 95% CI 1.52–3.65, p < 0.001) and postoperative intraventricular blood (OR 5.19, 95% CI 3.00–8.98, p < 0.001). Neither gross total nor subtotal resection showed significance for CSF diversion. Ventricle infiltration (OR 2.79, 95% CI 1.76–4.42, p < 0.001) and large tumor volume (OR 2.23, 95% CI 1.01–4.92, p = 0.05) were also identified as risk factors, while midline tumor was not. Subgroup analysis showed postoperative infection increased CSF diversion risk in children without initial hydrocephalus (OR 5.18, 95% CI 2.05–13.14, p = 0.04). Conclusion Preoperative hydrocephalus, preoperative PVL, medulloblastoma, ventricle infiltration, large tumor volume, and postoperative intraventricular blood increase the likelihood of CSF diversion following pediatric primary tumor resection.

Source: The Egyptian Journal of Neurology Psychiatry and Neurosurgery

DOI: 10.1186/s41983-026-01087-3

Authors: Bryan Gervais de Liyis, Kadek Dede Frisky Wiyanjana, Nyoman Golden, Sri Maliawan, Tjokorda Gde Bagus Mahadewa

Institution: Udayana University

Language: English

Topic: Cerebrospinal fluid and hydrocephalus

Subfield: Cellular and Molecular Neuroscience

Field: Neuroscience

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: diamond

Funder: Universitas Udayana