Posterior Fossa Lesions: An Experience of 32 Cases Over 1 Year

Introduction: Posterior fossa tumours are common inpaediatric population; however their occurrence in adults is notrare. They form a major cause of morbidity and mortality ineither population. Some of these tumours like pilocyticastrocytomas are rewarding, others, like medulloblastomasmay have a poor outcome. This study aims to analyse theepidemiology and surgical outcomes of posterior fossa lesions.Materials and Methods: This is a retrospective study done atDepartment of neurosurgery S.M.S Medical college Jaipur fromJanuary 2017 to December 2017. It included 32 patients withposterior fossa lesions. Cerebellopontine angle lesionsschwannomas, epidermoids were excluded. Only lesionsinvolving the cerebellum or occupying the fourth ventricle wereincluded in the study. Their surgical outcome in terms ofcomplications and mortality were analysed.Results: Thirty –two patients, in the age group of 2years to 68years were included in the study. Cerebello-pontine anglelesions were excluded. Only lesions involving the cerebellum oroccupying the fourth ventricle were included in the study. Mostcommon lesion was medulloblastoma, followed by pilocyticastrocytoma, cerebellar abscess, haemangioblastoma,arachnoid cyst, exophytic tectal gliomas, tuberculoma,metastasis, epidermoid. They underwent surgery dependingupon the nature of lesion. Overall mortality was found in 9 of 32patients. Mortality was especially high in medulloblastomapatients (54.55%).Conclusions: Various lesions may affect the posterior fossa,varying from neoplastic malignant or benign lesions to infectiveand developmental lesions. Medulloblastoma is a commontumour in the paediatric population and carries a badprognosis.

Stereotaxic Transcerebellar Approach for the Posterior Fossa Lesions with C.R.W. System

6 patients underwnet CT-guided stereotactic biopsy or hematoma aspiration procedure for posterior fossa lesions. Trajectory for biopsy or aspiration was transcerebellar approach. The patients were placed under general endotracheal anesthesia and positioned prone or sitting. No complications were encountered in the postoperative period when this technique was used. Stereotaxic transcerebellar multiple biopsy can safely provide tissue conformation of the neoplastic nature of a posterior fossa lesion thought to be a tumor. In addition, hematoma aspiration has been demonstrated to be safe, reliable, and efficient.