Ventriculoperitoneal Shunting for Brain Tumors

Brain tumors can cause obstructive hydrocephalus, which is often the major driver of clinical signs, especially in tumors arising within the ventricular system. VP shunting can provide rapid, effective, and durable relief from clinical signs of hydrocephalus secondary to brain tumors when used alone; however, it is more effective alongside other treatments such as radiation, chemotherapy, or surgery. VP shunting may offer standalone benefits to survival in patients, even without radiation therapy or surgery. Patients with progressive clinical signs of obstructive hydrocephalus, particularly those with ventricular system neoplasms or tumors affecting the caudal fossa, are ideal candidates for VP shunting. Other MRI features associated with clinical hydrocephalus include elevation of the corpus callosum, dorsoventral flattening of the interthalamic adhesion, dilation of the olfactory recesses, thinning of the cortical sulci and/or the subarachnoid space, and disruption of the internal capsule adjacent to the caudate nucleus. Meticulous planning and execution of the VP shunting procedure are essential to minimizing complications, which can include mechanical failures, functional failures, and infection. An additional surgical challenge commonly experienced with VP shunt placement in patients with brain tumors is that there is a smaller target area in which to place the shunt.