The role of contralateral ventricular dilatation following surgery for intracranial mass lesions.

Contralateral ventricular dilatation (CVD) has been described as an early indicator of tentorial herniation and has been associated with increased mortality and morbidity. Following surgery for supratentorial mass lesions, ipsilateral brain swelling often causes CVD. Drainage of CVD was performed in a series of 12 patients in whom no further lesion amenable to surgery was evident and after failure of other established methods of intracranial pressure (ICP) control. In 10 of the 12 patients the ICP was brought under control with a significant reduction in ICP (p < 0.05) when compared with predrainage ICP. Midline shift was reduced in seven patients. Therefore, following successful removal of intracranial mass lesions, patients who exhibit CVD should undergo drainage as an early measure.