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@ARTICLE{Kraus:302165,
      author       = {L. M. Kraus and M. Goldberg and E. Ursu and K. Demirbag and
                      S. P. Backhaus and G. Altawalbeh and D. Bernhardt and C.
                      Negwer and S. Combs$^*$ and B. Meyer and A. Wagner},
      title        = {{P}ostoperative hydrocephalus in patients with
                      infratentorial brain metastases may be influenced by
                      preoperative treatment: a single-center cohort study.},
      journal      = {Journal of neuro-oncology},
      volume       = {175},
      number       = {3},
      issn         = {0167-594X},
      address      = {Dordrecht [u.a.]},
      publisher    = {Springer Science + Business Media B.V},
      reportid     = {DKFZ-2025-01283},
      pages        = {1391-1399},
      year         = {2025},
      note         = {2025 Dec;175(3):1391-1399},
      abstract     = {Infratentorial brain metastases (BM), particularly those
                      causing obstruction of the fourth ventricle, are associated
                      with a significant risk of postoperative hydrocephalus. This
                      complication remains poorly understood, especially regarding
                      its predictors beyond mechanical obstruction. This study
                      aims to identify clinical predictors of postoperative
                      hydrocephalus in patients undergoing surgery for
                      infratentorial BM.We performed a single-center retrospective
                      analysis of 235 adult patients surgically treated for
                      infratentorial BM between 2009 and 2025. Patients with
                      leptomeningeal disease were excluded. Pre- and postoperative
                      hydrocephalus were defined based on imaging and clinical
                      criteria. Logistic regression and multivariate modeling were
                      used to evaluate predictors, including clinical
                      presentation, treatment history, and imaging
                      features.Postoperative hydrocephalus occurred in $18.45\%$
                      of patients. Breast cancer patients exhibited the highest
                      incidence $(30.61\%),$ significantly more than those with
                      lung cancer $(15.66\%,$ p = 0.042). Preoperative
                      hydrocephalus (p = 0.005), and prior chemotherapy (p =
                      0.001) or radiotherapy (p = 0.004) were significantly
                      associated with postoperative hydrocephalus. Imaging
                      variables, including tumor volume or proximity to the fourth
                      ventricle, were not predictive. Multivariate regression
                      confirmed preoperative hydrocephalus, and systemic treatment
                      as independent risk factors.Postoperative hydrocephalus in
                      infratentorial BM is influenced not only by mechanical
                      factors but also by preoperative clinical and therapeutic
                      variables. Breast cancer patients, particularly those who
                      received prior systemic or local therapy, are at higher
                      risk. These findings suggest the need for individualized
                      risk assessment and raise the question of whether
                      prophylactic interventions could mitigate complications and
                      treatment delays in high-risk cohorts.},
      keywords     = {Chemotherapy (Other) / Hydrocephalus (Other) /
                      Infratentorial brain metastases (Other) / Radiotherapy
                      (Other)},
      cin          = {MU01},
      ddc          = {610},
      cid          = {I:(DE-He78)MU01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40551067},
      doi          = {10.1007/s11060-025-05125-7},
      url          = {https://inrepo02.dkfz.de/record/302165},
}