PITCH registry study design: Pediatric Infratentorial Tumors – Related Complications of Hydrocephalus. Observational, prospective, multicenter study evaluating mortality, infection rate, and number of surgeries associated with the treatment of hydrocephalus secondary to infratentorial tumors in childhood and adolescence

Introduction: Posterior fossa tumors are the main pediatric solid neoplasms, and more than 60% of these tumors are associated with the occurrence of hydrocephalus, which can be treated through different strategies, such as endoscopic third ventriculostomy (ETV), ventriculoperitoneal shunt (VPS), external ventricular drainage (EVD), or direct resection of the lesion without other diversion methods. The safest and most efficient drainage method remains controversial, and several studies are limited to a single center, with retrospective analysis, most of them compromised by the limited number of participants, so multicenter and prospective studies are necessary to understand what would be the best treatment strategy. Methods: This is a non-concurrent, prospective, multicenter cohort study conducted in more than twenty pediatric neurosurgery centers in Latin America, in which patients will be divided into 4 groups according to the chosen treatment for hydrocephalus (ETV, EVD, VPS, and resection), and mortality and infection rates, the number of surgeries related to hydrocephalus treatment, and its complications in the first year of hydrocephalus treatment will be analyzed. Patients will be followed prospectively for up to 12 months after the index surgery, which will be considered the surgery performed for the treatment of hydrocephalus, and each group will include at least 100 patients. Conclusion: The online REDCap platform will be used for the records of the PITCH study, which will allow the collection of prospective data in different centers in Latin America, aiming to compare the treatment modalities for obstructive hydrocephalus secondary to posterior fossa tumors (ETV, EVD, VPS, resection) and to evaluate the impact of these treatments in the first year after the diagnosis of hydrocephalus associated with posterior fossa tumor.