¹   Dr. Zia Ur Rehman, ²Dr. Haider Ali

¹ Assistant Professor Department of Neurosurgery MTI/ Lady Reading Hospital – Peshawar

² Registrar Neurosurgery LRH

Correspondence: Dr. Haider Ali Registrar Neurosurgery LRH

Abstract

Abstract   Background: Hydrocephalus, characterized by the accumulation of cerebrospinal fluid (CSF) within the brain’s ventricles, often arises from CP angle tumors like acoustic neuromas and meningiomas. These tumors can obstruct CSF pathways, increasing intracranial pressure (ICP) and causing neurological impairments. Ventriculoperitoneal (VP) shunting is a common intervention that diverts excess CSF from the brain to the peritoneal cavity, alleviating symptoms and preventing further neurological decline. Objective: This study aims to evaluate the efficacy of VP shunting in patients with hydrocephalus induced by CP angle tumors, focusing on changes in ICP, neurological function, and quality of life (QoL). Methods: This prospective observational study was conducted at Lady Reading Hospital, Peshawar, from January 2020 to December 2023. The study included 200 patients diagnosed with hydrocephalus secondary to CP angle tumors. Participants ranged in age from 18 to 75 years, with a mean age of 45.3 years. Both male (n=110) and female (n=90) patients were included. All participants underwent VP shunting performed by experienced neurosurgeons. Data on ICP, assessed using invasive monitoring techniques, and neurological function, evaluated by the Glasgow Coma Scale (GCS), were collected pre- and post-surgery. QoL was assessed using the SF-36 survey, and hospital readmission rates were recorded. Statistical analysis, including paired t-tests and chi-square tests, was performed using SPSS version 25.0. Results: VP shunting significantly reduced ICP from a mean of 25.4 mmHg (SD = 5.1) to 12.7 mmHg (SD = 3.8) post-surgery (p < 0.001). GCS scores improved from a mean of 9.2 (SD = 3.5) to 13.6 (SD = 2.1) (p < 0.001). QoL scores increased from 40.5 (SD = 15.3) to 75.2 (SD = 10.7) at the six-month follow-up (p < 0.001). Hospital readmission rates decreased from 20% to 5% within 30 days postsurgery (p < 0.01). Conclusion: The study demonstrates that VP shunting effectively improves ICP, neurological function, and QoL in patients with hydrocephalus induced by CP angle tumors. These findings support VP shunting as a primary treatment option for this condition, with significant implications for clinical practice and patient care. Keywords: Ventriculoperitoneal shunting, hydrocephalus, CP angle tumors, intracranial pressure, neurological function, quality of life, neurosurgery.