Authors
Molchanov I.P., Dimertsev A.V., Zuev A.A.
Pirogov National Medical and Surgical Center, Moscow
Abstract
Giant intracranial neoplasms compressing and extending into various compartments of the cerebrospinal fluid (CSF) system of the brain contribute to alterations in CSF dynamics, which may affect clinical outcomes in the early postoperative period. Our report describes a case of ventriculoperitoneal shunt overdrainage following resection of a giant petroclival meningioma, as well as the specific features of patient management in such a condition.
Keywords: cerebrospinal fluid, ventriculoperitoneal shunt, overdrainage, giant petroclival meningioma.
References
1. Filis AK, Aghayev K, Vrionis FD. Cerebrospinal fluid and hydrocephalus: physiology, diagnosis, and treatment. Cancer Control. 2017; 24(1): 6-8. doi: 10.1177/107327481702400102.
2. Zhao Z, Yuan X, Yuan J, et al. Treatment strategy for petroclival meningiomas based on a proposed classification in a study of 168 cases. Sci Rep. 2020; 10(1): 4655. doi: 10.1038/s41598-020-61497-y.
3. Alekseev IM, Turabekov NN, Dimertsev AV, Zuev AA. Khirurgicheskoe lechenie patsientov s gigantskimi petroklival’nymi meningiomami. Neirokhirurgiya. 2025; 27(1): 10-21. (In Russ.) doi: 10.24412/2587-7569-2025-1-10-21.
4. Ichimura S, Kawase T, Onozuka S, et al. Four subtypes of petroclival meningiomas: differences in symptoms and operative findings using the anterior transpetrosal approach. Acta Neurochir. 2008; 150(7): 637-645. doi: 10.1007/s00701-008-1586-x.
5. Wong JM, Panchmatia JR, Ziewacz JE, et al. Patterns in neurosurgical adverse events: intracranial neoplasm surgery. Neurosurg Focus. 2012; 33(5): E16. doi: 10.3171/2012.7.FOCUS12183.
6. Hong B, Polemikos M, Heissler HE, et al. Challenges in cerebrospinal fluid shunting in patients with glioblastoma. Fluids Barriers CNS. 2018; 15(1): 16. doi: 10.1186/s12987-018-0101-x.
7. Hönikl LS, Lange N, Barz M, et al. Postoperative communicating hydrocephalus following glioblastoma resection: incidence, timing and risk factors. Front Oncol. 2022; 12: 953784. doi: 10.3389/fonc.2022.953784.
8. Gosal JS, Behari S, Joseph J, et al. Surgical excision of large-to-giant petroclival meningiomas focusing on the middle fossa approaches: the lessons learnt. Neurol India. 2018; 66(5): 1434-1446. doi: 10.4103/0028-3886.241354.
9. Vargas-Moreno A, Khairy S, Saymeh M, et al. Predictors, complications, and clinical outcomes of cerebrospinal fluid leak post endoscopic endonasal skull base surgery. Brain Sci. 2025; 16(1): 19. doi: 10.3390/brainsci16010019.
10. Ros B, Iglesias S, Linares J, et al. Shunt overdrainage: reappraisal of the syndrome and proposal for an integrative model. J Clin Med. 2021; 10(16): 3620. doi: 10.3390/jcm10163620.
11. Zhou L, Yu J, Sun L, et al. Overdrainage after ventriculoperitoneal shunting in a patient with a wide depressed skull bone defect: the effect of atmospheric pressure gradient. Int J Surg Case Rep. 2016; 29: 11-15. doi: 10.1016/ j.ijscr.2016.10.012.
12. Ros B, Iglesias S, Martín Á, et al. Shunt overdrainage syndrome: review of the literature. Neurosurg Rev. 2018; 41(4): 969-981. doi: 10.1007/s10143-017-0849-5.
13. Jang M, Yoon SH. Hypothesis for intracranial hypertension in slit ventricle syndrome: new concept of capillary absorption laziness in the hydrocephalic patients with long-term shunts. Med Hypotheses. 2013; 81: 199-201.
14. Demir O, Deniz FE. A clinical experience with decompressive craniectomy. Turk Neurosurg. 2020; 30(5): 637-642. doi: 10.5137/ 1019-5149.JTN.24871-18.2.
15.Panagopoulos D, Stranjalis G, Gavra M, et al. Shunt over-drainage, slit ventricle syndrome, programmable valves and anti-siphon devices: a narrative review of a multifactorial and intractable problem. J Integr Neurosci. 2022; 21(3): 84. doi: 10.31083/j.jin2103084.
16. Gürer B, Yilmaz ER, Kertmen HH, Sekerci Z. Shunt overdrainage after mild head trauma. Clin Neurol Neurosurg. 2012; 114(2): 196-198. doi: 10.1016/j.clineuro.2011.10.006.
17. Koueik J, Kawtharani S, Iskandar BJ. Reversible severe brainstem herniation and obstructive hydrocephalus from cystoperitoneal shunt overdrainage. World Neurosurg. 2019; 126: 588. doi: 10.1016/j.wneu.2019.03.231.
