Background: Hydrocephalus may occur after subependymal giant cell astrocytoma (SEGA) resection. In existing literatures, SEGA almost always occurred in patients with tuberous sclerosis complex (TSC), however, many SEGA also occurred alone in our Chinese pediatric patients.
Objective: To discuss the risk factors of postoperative hydrocephalus following SEGA resection and the relationship between SEGA and TSC in Chinese children.
Materials and methods: A total of 35 children (≤18-year-old) who underwent SEGA resection were selected. From 3 months postoperatively until December 2020 all patients received telephone or clinical follow-up. Related risk factors were first screened by univariate analysis and then analyzed by multivariate logistic regression.
Results: The ratio of males to females was 3:2 and the mean age was 11.6 years. Twenty cases were associated with TSC and 15 were not. The mean maximum diameter of the SEGA for patients with and without associated TSC was 49.7mm and 30.5mm, respectively (Z=-3.293, P=0.001). Twenty-eight patients had preoperative hydrocephalus. Sixteen patients developed postoperative hydrocephalus, and amongst these, 2 did not have hydrocephalus before surgery. Multivariate analysis showed that association with TSC [odds ratio (OR), 18.81, P=0.048] and tumor resection rate (OR, 0.042, P=0.025) were independent risk factors for postoperative hydrocephalus.
SEGA could be associated with TSC or appear alone. The maximum diameter of SEGA associated with TSC is larger than that without TSC. Hydrocephalus is a common onset symptom and might recur following SEGA resection. Association with TSC and tumor resection rate are risk factors for postoperative hydrocephalus.