Insertion of a VP shunt represents the most frequent method of choice of the surgical treatment of hydrocephalus, but also potentially a highly risky procedure followed by various complications about which parents should be informed when patients are children. Owing to adequate approach in the follow-up of children with implanted VP shunt, large bowel and urinary bladder perforation, examples of severe and potentially fatal complications of this surgical intervention, could be disclosed on time and adequately resolved.

No statistically significant difference was detected in the outcome between the patients treated by the standard method and those with installed Ommaya reservoir. However, the difference of 10% in mortality between the two groups may be clinically significant so that further studies of larger samples are necessary.

Introduction. We report a series of 30 patients with spontaneous intraventricular hemorrhage (IVH) and hydrocephalus, in which is placed subcutaneous (Omaya) tank at the University Children?s Hospital in Belgrade from March 2006 to March 2011. Results. Predictors of poor outcome in treatment in getting Omaya reservoirs are low birth weight (t=2.560, p=0.016), low Apgar score (t=3.059, p=0.005), an extended number of days on mechanical ventilation (Z=4,404 , p< 0.001), the presence of peripartal asphyxia (X2=9.977, p=0.002) and cardio-respiratory arrest (X2=12.804 , p< 0.001). Conclusion. The outcome of treatment of hydrocephalus caused by spontaneous intraventricular hemorrhage in premature infants is worst in perinatology. There is no consensus on the diagnosis and treatment of posthemorrhage hydrocephalus, our results suggest that the main prediction factor is preoperative condition of the child.

During the period of 2009-2011 in UCH in Belgrade, we treated 22 patients with brain tumors. Treatment included the diagnosis and therapy that included surgery and postoperative neuroradiological follow-up of all patients regardless of whether radiotherapy was conducted with or without chemotherapy. The most frequent were low grade astrocytomas and medulloblastomas. Patients with supratentorial localization of tumor had significantly smaller neurological sequelae compared with patients with infratentorial as well as patients diagnosed with low grade astrocytomas of any localization. From 10 patients with supratentorial localization, 7 of them had no neurological deficit, while from 11 patients with infratentorial localization, 3 of them were Without deficit. Patients with histological diagnosis of low grade astrocytoma of any localization had less neurological deficits compared with other tumors. From 7 low grade astrocytoma in 5 of them there was no neurological deficit, while only in one patient residual tumor was verified. In 7 patients the rest of the tumor was diagnosed, while in 14 patients no residual tumors was diagnosed during follow-up based on the MRI diagnosis. Surgery, postoperative radiotherapy and chemotherapy in some cases represent an effective therapeutic approach in the treatment of brain tumors in children.

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