Communicating hydrocephalus in glioblastoma presenting as chronic hydrocephalus: systematic review and meta-analysis

Objective: Communicating hydrocephalus (CH) is an uncommon complication that can affect patients with glioblastoma (GBM). Due to its clinical and radiological findings, it presents as a chronic hydrocephalus. The mechanisms underlying its occurrence and impact on the prognosis of the disease are poorly known, but some studies have suggested that shunting can have a positive impact on the quality of life of these patients. Methods: The authors performed a systematic literature review and meta-analysis to identify the possible risk factors that could help to identify CH cases in glioblastoma, using the MEDLINE/PubMed and Cochrane Database of Systematic Reviews databases. The Joanna Briggs Institute critical appraisal tool was used to assess the risk of bias. Results: Our search yielded 273 studies, but only 9 records were included in the final quantitative analysis. CH in glioblastoma patients was found to be very uncommon (proportion 0.04 out of 1; range 0.03–0.05, p < 0.01, CI:95%) and its occurrence was associated with a previous ventricular opening (0.85 out of 1; range 0.66–0.94, p < 0.01, CI:95%). Conclusion: CH in glioblastoma should be suspected in patients with GBM who have undergone accidental ventricular opening during tumor resection and presenting with chronic hydrocephalus symptoms.