Posterior Fossa Tumors in Adult Patients

Objective Obstructive hydrocephalus in patients with posterior fossa tumors is frequently seen. Treatment options include immediate tumor removal or prior cerebrospinal fluid (CSF) diversion procedures. The necessity and feasibility of an ETV in these situations has not yet been proven in adult patients. Methods We retrospectively reviewed our prospectively maintained database for ETVs before surgery of posterior fossa tumors in adults. The primary focus of data analyses was the question of whether the ETV was suitable to treat the acute situation of hydrocephalus without an increased rate of complications due to the special anatomical situation with a posterior fossa tumor. We also analyzed whether any further CSF diverting procedures were necessary. Results A total of 40 adult patients who underwent an ETV before posterior fossa tumor surgery were analyzed. Overall, 33 patients (82.5%) had clinical signs of hydrocephalus, and all of them improved in their clinical course after ETV. Seven patients (17.5%) did not demonstrate clinical signs of hydrocephalus, but ETV was performed with prophylactic or palliative intent in six patients and one patient, respectively. No complications were observed due to ETV itself. No permanent shunting procedure was necessary in a mean follow-up of 76.5 months. Early additional CSF diverting procedures (redo ETV, external ventricular drain) were performed in five patients (12.5%). Conclusion The present series confirms the feasibility and safety of ETV before posterior fossa tumor surgery in adult patients. If patients had symptomatic hydrocephalus before tumor surgery, an ETV can be performed, followed by early elective tumor surgery. A prophylactic ETV in asymptomatic patients is not advised. Early elective tumor surgery should be performed in these patients.

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Persistent hydrocephalus after early surgical management of posterior fossa tumors in children: is routine preoperative endoscopic third ventriculostomy justified?

Yearbook of Neurology and Neurosurgery ◽

10.1016/s0513-5117(08)70146-7 ◽

2007 ◽

Vol 2007 ◽

pp. 213-214

Author(s):

M.R. Proctor

Keyword(s):

Posterior Fossa ◽

Surgical Management ◽

Endoscopic Third Ventriculostomy ◽

Third Ventriculostomy ◽

Posterior Fossa Tumors ◽

Persistent Hydrocephalus

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Faculty Opinions recommendation of The effects of posterior fossa decompressive surgery in adult patients with Chiari malformation and sleep apnea.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.3150957.2838055 ◽

2010 ◽

Author(s):

Thomas Milhorat ◽

Misao Nishikawa

Keyword(s):

Sleep Apnea ◽

Posterior Fossa ◽

Chiari Malformation ◽

Adult Patients ◽

Decompressive Surgery

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The assessment of executive functioning in pediatric patients with posterior fossa tumors: A recommendation to combine caregiver-based ratings and performance-based tests

Developmental Neurorehabilitation ◽

10.1080/17518423.2021.1915404 ◽

2021 ◽

pp. 1-10

Author(s):

Hoffmann-Lamplmair Doris ◽

Ritter Irene ◽

Leiss Ulrike ◽

Slavc Irene ◽

Pletschko Thomas

Keyword(s):

Executive Functioning ◽

Posterior Fossa ◽

Pediatric Patients ◽

Posterior Fossa Tumors ◽

And Performance

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Shunt Metastases in Posterior Fossa Tumors

Neuropediatrics ◽

10.1055/s-0028-1085332 ◽

1979 ◽

Vol 10 (03) ◽

pp. 296-300 ◽

Cited By ~ 10

Author(s):

Rainer Oberbauer ◽

Hans Tritthart ◽

Peter Ascher ◽

Gerhard Walter ◽

H. Becker

Keyword(s):

Posterior Fossa ◽

Posterior Fossa Tumors

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Hydrocephalus Associated with Posterior Fossa Tumors: How to Manage Effectively?

Neurology India ◽

10.4103/0028-3886.332260 ◽

2021 ◽

Vol 69 (8) ◽

pp. 342

Author(s):

Natarajan Muthukumar

Keyword(s):

Posterior Fossa ◽

Posterior Fossa Tumors

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PAEDIATRIC POSTERIOR FOSSA TUMORS : AN EPIDEMIOLOGICAL AND ANALYTICAL STUDY AT TERTIARY CARE CENTRE IN EASTERN INDIA

10.36106/ijar/6409694 ◽

2021 ◽

pp. 54-56

Author(s):

S. I. Sadique ◽

Md. Shahid Alam ◽

S. Chatterjee ◽

S. Ghosh

Keyword(s):

Early Diagnosis ◽

Posterior Fossa ◽

Tertiary Care ◽

Male Dominance ◽

Morbidity And Mortality ◽

Posterior Fossa Tumors ◽

Tertiary Care Centre ◽

Therapeutic Modalities ◽

Common Location ◽

Group 5

Introduction: Posterior fossa is the commonest site of primary intracranial tumors in children, accounting for 45-60% of 1 all pediatric tumors . The aims and objectives of the study is to analyse the incidence, clinical features, surgical outcome and complications in paediatric patients with posterior fossa tumor. Material and Methods: The present study is a non-randomized prospective observational study, conducted in the department of neurosurgery, Bangur Institute of Neurosciences (B.I.N), IPGME & R, Kolkata from January 2019 to December 2020. Sample size is 50. Observations & Results: Out of 480 cases of total CNS tumors who presented in the study period, 96 cases(20%) were of paediatric posterior fossa tumors. Male dominance was seen i.e. 32 cases(64%). Most of them were in the age group 5-12 years i.e. 30 cases(60%). Headache and vomiting was the most common presenting complain present in 41 cases(82%). Fourth Ventricle was the most common location, 30 cases(60%) with Medulloblastoma being the most common tumor, 24 cases(48%). Brainstem involvement was seen in 22 cases(44%). Post-op hydrocephalus and cerebellar mutism were seen in 6 cases(12%) each. Overall mortality was 8%(4 cases). Conclusion: Posterior fossa tumors are critical brain lesions with signicant neurological morbidity and mortality. Early diagnosis of posterior fossa tumors is vital to prevent potential risks of Brain stem compression, herniation, hydrocephalus and death. With rapid advancement in radiology and the advent of modern therapeutic modalities, early diagnosis and treatment reduced the morbidity and mortality rate and improved prognosis among the patients.

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