This is a retrospective study on 41 cases with hydrocephalus caused by posterior fossa tumors treated at neurosurgery Dep., Cho Ray hospital from 1993 to 1995. All child patients entering the study had the intracranial pressure syndrome and evidence clinical, paraclinical symptoms. 18/41 cases had cerebellar symptoms (50%). 27 cases had the pathological results after tumor removal in which 20 cases were medulloblastoma (74.04%). The percentage of patients becoming worse postoperatively was still high: 7/27 cases (25.92%). To enhance the quality of treatment, it is necessary to make the diagnosis early and treat the patients actively.
Infratentorial Neoplasms ; Hydrocephalus

The authors experienced a case of mutism developed after the posterior fossa tumor surgery in a child. Mutism is a symptom mainly developed by supratentorial lesion in organic form. The possible pathogenesis of mutism after posterior fossa tumor surgery is discussed with a review of 18 additional previously reported cases.
Child* ; Humans ; Infratentorial Neoplasms* ; Mutism*

Traumatic hematomas in the posterior fossa is relatively rare (only 2.8% in the total cases of hematomas in the cranium), but dangerous because clinical symptoms are not specific and sudden suspension of breathing may lead rapidly to mortality. The author had analysed these cases to find out experiences in the diagnosis and treatment of this disease. The rate of mortality after surgery and medical treatment was 14.3%.
Hematoma ; Diagnosis ; Therapeutics ; Infratentorial Neoplasms

Spontaneous ventriculostomy occurs with the spontaneous rupture of a ventricle resulting in a communication between ventricular system and subarachnoid space. It is usually the result of obstructive hydrocephalus but has been documented only rarely. Van Stackum verified the first case of spontaneous ventriculostomy at autopsy in 1910. Radiological demonstration of spontaneous ventriculostomy was reported by Leslie for the first time in 1964 and only 6 cases has been reported until now. We recently have experienced a case of spontaneous ventriculostomy beautifully demonstrated by conray ventriculography in a patient of posterior fossa tumor. We report our case with the brief review of the articles.
Autopsy ; Humans ; Hydrocephalus ; Infratentorial Neoplasms ; Rupture, Spontaneous ; Subarachnoid Space ; Ventriculostomy*

A rare case of hemifacial spasm caused by an ipsilateral tentorial meningioma is described. Magnetic resonance imaging showed a huge tumor in the right cerebellar hemisphere, distant to the cerebello-pontine cistern. The facial-vestibulocochlear nerve complex was stretched by the shift of the brainstem and the right cerebello-pontine cistern was effaced. After removing the tumor, the hemifacial spasm resolved completely. We review our case with the pertinent literature regarding the etiological mechanism.
Brain Stem ; Hemifacial Spasm ; Infratentorial Neoplasms ; Magnetic Resonance Imaging ; Meningioma

The authors analyzed 50 children(below 15 years old) with intracranial tumors which were confirmed by operation during 5.5 years from Jan, 1983 to Jul. 1989 retrospectively. The results were as follows : 1) Incidence of pediatric brain tumors was 13.1% among the all intracranial tumors(383 cases). 2) Pediatric brain tumors were found most frequently between the age of six and thirteen years(74.0%), and the ratio of male to female was 1.6 : 1. 3) In respect of location, supratentorial and infratentorial tumors were seen in each 25 patients, and the tumor of central neural axis(58.0%) was more frequent than that of lateral portion(42.0%). 4) The most common tumor was astrocytoma(32.0%) in the supratentorium, and medulloblastoma(26.0%) in the infratentorium. 5) Headache and vomiting were the most common complaining symptoms and papilledema was the most common sign. 6) Hydrocephalus associated with tumors was 24.0% in supratentorium and 88.0% in infratentorium. 7) Postoperative mortality within 1 month was 12.0%.
Brain Neoplasms* ; Brain* ; Female ; Headache ; Humans ; Hydrocephalus ; Incidence ; Infratentorial Neoplasms ; Male ; Mortality ; Papilledema ; Retrospective Studies ; Vomiting

A 24-year-old female patient presented with a midline extra-axial posterior fossa lesion. We failed to suspect this lesion could be a giant thrombosed aneurysm of PICA(posteior inferior cerebellar artery) preoperatively, and didn't perform preoperative angiogram even after rather typical finding of thrombosed giant aneurysm on MRI. We suggest a giant thrombosed aneurysm should be included in the differantial diagnosis of any round extra-axial mass lesion in the skull base.
Aneurysm* ; Arteries* ; Diagnosis ; Female ; Humans ; Infratentorial Neoplasms* ; Magnetic Resonance Imaging ; Pica ; Skull Base ; Young Adult

OBJECTIVE: This study is designed to identify the clinical characteristics and the optimal treatment modality of hydrocephalus in posterior fossa tumors. METHODS: The authors reviewed 154 infratentorial tumor patients. Age, sex, clinical symptoms, types of treatment, and surgical results of posterior fossa tumor patients with hydrocephalus were analyzed, retros-pectively. Factors which might predict the need for external ventricular drainage(EVD) or ventriculo-peritoneal shunt were analyzed statistically. RESULTS: Hydrocephalus was noted in 86 cases(56%), and it was associated with medulloblastoma in 16 cases(89%), hemangioblastoma in 12(63%) and brain stem glioma in three(33%). The surgical results of the posterior fossa tumors with hydrocephalus were poorer than those without hydrocephalus(p<0.05). A large tumor(p<0.05) and an incomplete removal(p<0.05) were factors predicting the need for EVD or shunt. Complications of intraoperative EVD or shunt developed in four cases. They were infection, he-morrhage at puncture site, and obstruction. Five patients in whom intraoperative EVD or shunt had not been performed developed a fatal hydrocephalic attack at immediate postoperative period, and the pos-toperative computed tomography scan revealed intraventricular hemorrhages in three cases cerebellar swellings in two cases. CONCLUSION: Intraoperative EVD or shunt is a safe, effective treatment modality especially in large size tumor and/or incomplete tumor resection. Intraventricular hemorrhages or cerebellar swellings during immediate postoperative period might cause fatal hydrocephalic attack, therefore EVD or shunt might be recommended in selected cases.
Brain Stem ; Glioma ; Hemangioblastoma ; Hemorrhage ; Humans ; Hydrocephalus* ; Infratentorial Neoplasms* ; Medulloblastoma ; Postoperative Period ; Punctures ; Ventriculoperitoneal Shunt

Medulloblastoma is one of the most undifferentiated primitive neuroectodermal tumors and represents about 30% of all posterior fossa tumors in children. Disseminated medulloblastoma, mainly involving cerebral surfaces, ventricles and the subarachnoid space can, in 50% of patients, be identified on intial imaging studies. One thirdof these lesions metastasize to an extracranial site, primarily to bone. Osseous metastases, which occur mainly after craniectomy are typically lytic, but osteoblastic lesions also may occur. We experienced the case of a 14year-old female patient with multiple bone metastases of medulloblastoma after craniectomy. Bone metastaticlesions were present in the right femur and thoracic spine and were osteoblastic or osteolytic
Child ; Female ; Femur ; Humans ; Infratentorial Neoplasms ; Medulloblastoma* ; Neoplasm Metastasis* ; Neuroectodermal Tumors, Primitive ; Osteoblasts ; Spine ; Subarachnoid Space

Intracranial gliomas were found more commonly in childhood(70 to 80%) than in adulthood(40 to 45%). The common infratentorial tumors in children were cerebellar astrocytoma(26.9%), medulloblastoma(18.5%) and brain stem glioma(10.5%). Brain stem gliomas were infiltrating type of tumor and frequently involved the pons and medulla. An almost pathognomic syndrome of the brain stem gliomas consists in the presences of multiple bilateral cranial nerve abnormalities in combination with involving signs of pyramidal tract and cerebro-dentato-rubro-thalamic tract in the absence signs of increased ICP, especially in the early stage. These tumors take grave course because of clinical malignancy and lack of definite therapy. Once diagnosed, radiation therapy was at best palliative treatment. Sometimes surgical therapy could be attempted to find out curable cysts. We have been experienced in a case of brain stem glioma recently that was confirmed with an autopsy;astrocytoma grade II to III, microscopically.
Brain Stem* ; Brain* ; Child ; Cranial Nerves ; Glioma* ; Humans ; Infratentorial Neoplasms ; Palliative Care ; Pons ; Pyramidal Tracts