Surgical Management and Short-Term Outcome of Patients with Posterior Fossa Tumor in All Age Groups: Our Perspective

Abstract

Background: Different types of brain tumor can occur in the region of posterior fossa. Ependymoma, medulloblastoma and pilocytic astrocytoma occur mostly in children and rarely in adults. Brain metastases in adults are the most common malignancies at this site. Other tumors that occur in the posterior fossa are meningioma, schwannoma, hemangioblastoma, brain stem glioma and epidermoid tumors. Posterior fossa tumor has different treatment approaches and prognosis. So, an accurate diagnosis, surgical approaches, complication analysis and outcome assessment are mandatory. Objective: To evaluate the clinical aspects, surgical approach, role of preoperative shunt, post-operative complications, and short-term outcome of patients with posterior fossa tumor in different age groups. Methods: This cross-sectional observational study included 36 patients with posterior fossa tumors that were admitted and operated in the Neurosurgery Department of Rangpur Medical College Hospital between the period of November 2018 and June 2022. In each patient clinically diagnosis was confirmed by MRI of Brain with contrast followed by histopathology. Results: Out of 36 patients, 23(63.9%) patients were male and 13(36.1%) were female. Mean age was 18.01±13.95 SD years (minimum 6 months and maximum 45 years), more common in pediatric age group (36.1% <10 years and 25% between 11-20 years). Common presentations were headache (91.6%), vomiting (83.3%) and ataxia (72.2%). Medulloblastoma (27.8%) and ependymoma (25%) were common histological types. Surgical outcome was excellent in 17 cases (47.2%), while poor in 5.6% and 19.4% patients died. There was no statistically significant association of surgical outcome with age (p=0.148) and sex (p=0.170). Suboccipital craniotomy was superior to other surgical procedures in terms of patient’s outcome (p=0.031). Ependymomas and Astrocytomas had better outcome (p=0.014). Conclusions: Surgical outcome is related to the operative approach and histology of the tumor in this study, but no significant association of patient’s outcome with age, sex and preoperative procedure.

J Rang Med Col. March 2024; Vol. 9, No. 1: 3-9