Improved Survival and Symptom Relief Following Palliative Cerebrospinal Fluid Diversion for Leptomeningeal Disease from Brain Cancers: A Case Series and Systematic Review

Abstract

Leptomeningeal disease from cancer indicates widespread or advanced cancer and can lead to obstructive hydrocephalus, for which palliative cerebrospinal fluid diversion may be indicated to relieve symptoms, such as headaches and nausea. The authors of this study performed a review of published clinical outcomes for patients diagnosed with hydrocephalus from leptomeningeal disease. In addition, an analysis of a single-institution case series of adult patients was conducted to evaluate surgical outcomes, including complication and symptom relief rates. Symptom relief and improved survival can be achieved with permanent cerebrospinal fluid diversion for palliative purposes with low complication rates. Hence, this patient population may benefit from surgery to alleviate symptoms from hydrocephalus despite the poor prognoses development of leptomeningeal disease portends. Still, prospective studies are needed in the future to evaluate specific needs and impacts on quality of life for these patients.