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Akdeniz University Faculty of Medicine Department of Neurosurgery, Antalya, Turkey The factors for recommending postoperative VP shunt insertion in twenty-eight pediatric patients, previously operated on for posterior fossa tumor, without V-P shunt preoperatively are investigated in this study. Age, sex, the preoperative duration for high intra-cranial pressure (lCP) signs, the preoperative hydrocephalic index, tumor size, tumor location, the extent of tumor resection, the use of external ventricular drainage (EVD) and its duration, postoperative ICP records, complications and histopathological diagnosis between the groups with and without V-P shunt are collected and compared. In 8 (28.57 %) of cases, V-P shunt was inserted in the postoperative period. Young age at diagnosis, the extent of tumor resection, prolongation in EVD duration and postoperatively high ICP levels are found to be statistically significant factors for shunt insertion in the postoperative period. Keywords : Pediatric, posterior fossa tumor, V-P shunt