The role of angiography and ventriculovenous shunting in the treatment of posterior fossa tumors.

Abstract

Angiography followed by a ventriculovenous or ventriculoperitoneal shunt is recommended as the initial procedure for patients with hydrocephalus secondary to posterior fossa tumors. With increasing regularity, the angiogram has proven to be of sufficient localizing value to warrant surgery, and the shunt has resulted in easier operative procedures and a smoother postoperative course. If exact localization is not afforded by the angiogram, then ventriculography or pneumoencephalography can be carried out deliberately in a cooperative patient who is no longer ill from pressure and whose nutrition and general state of health has improved. The use of modern neuroradiological techniques combined with shunting has virtually eliminated posterior fossa “exploration” with its concommitant manipulation of normal structures, unnecessary puncturing of the cerebellar hemispheres and excessive bony removals.