Spectrum of Posterior Fossa Lesions: Experience at Tertiary Care Unit

Objective: The objective of our study was to evaluate the frequency and surgical outcome of patients with posterior fossa lesions.Material and Methods: This observational, descriptive study was conducted in the department of neurosurgery at lady reading hospital Peshawar and PUMH Nawabshah from Jan 2014 - June 2018. A total of 163 patients were observed during the study period. All those patients who undergone surgery for intra-axial posterior fossa tumors were included in the study. We included patients of both the genders and all age groups. We took approval of the study from the hospital ethical committee and informed consent was taken from the patients or their relatives. The data was entered in a specially designed Performa. Patients’ data was analyzed using SPSS version 21.Results: We had total 163 patients during the study period who fulfilled the inclusion criteria. Most (80.4%) of the patients were in the pediatric age groups and male (57%). Age of the patients ranged from 1-65 years with the mean age 17.4 years. The most common tumors in our study were Medulloblastoma (33.1%), Ependymoma (22.7%) and Astrocytoma (19%) in descending orders. Hemangioblastoma and metastasis were seen in 6.1% cases each. The most common clinical features were headache (87.1 %) and vomiting (64.4%) cases. Most (74.8%) of the patients undergone sub-occipital tumor excision. The most common post-operative complications in descending orders were tumor bed hematoma (6.7%), wound infection (4.9%) and cerebrospinal fluid (CSF) leak (4.9%). Total mortality was observed in 12.3% cases.Conclusion: We conclude from our study that posterior fossa tumors are more common in male children. The most frequent tumors in posterior fossa are Medulloblastoma, Ependymoma and Astrocytoma. Tumors is excision (66%) is the main treatment option. The rest need CSF diversion procedures. The main post-operative complications are tumor bed hematoma, wound infection and cerebrospinal fluid leak. Mortality is high in such patients. Most patients had good and satisfactory outcome after surgery