Surgical Management of Midline Posterior Fossa Tumours

Abstract

Background: Tumors in the posterior fossa considered as a critical brain lesions. Radiation therapy may be the only or the main line of treatment as in diffuse brain stem gliomas or represents a complementary treatment after surgery as the condition in medulloblastomas and ependymomas.

Objective: to study clinical presentation, pathology, methods of investigations, operative techniques, complications of management of midline posterior fossa tumors and eventually prognosis.Also, this study aims at comparing the results of different types of management in order to establish the optimum way for management of midline posterior fossa tumors.

Patients and methods: This study was conducted on 30 patients at the neurosurgical department at SOHAG EL-HELAL health insurance, 6 OCT. between OCT 2012 and OCT 2014.

Results: the peak incidence of tumer was between 3 to 10 years old patients. The most common presenting features in this study were manifestations of increased ICP with predominance of headache and vomiting. 26.7% of cases had cranial nerves affection.  80% of cases in this study presented with surpratentorial hydrocephalus.The commonest post-operative complications in this study were cerebellar symptoms. It showed that CSF diversion decreased the risk of post-operative complications.

Conclusion: Patients with definite neurological symptoms and signs of increased ICP and/or cerebellar dysfunction and their CT brains were not conclusive should be investigated with MRI (with and without contrast) before exclusion of posterior fossa tumors.