POSTERIOR-FOSSA MENINGIOMAS - SURGICAL EXPERIENCE IN 52 CASES

Background Early reports of the surgical management of posterior crani al fossa meningiomas (PCFM) yielded poor results with high rates of mo rtality and morbidity. With the advent of modern neuroimaging and micr osurgical techniques the results of surgery have improved markedly, bu t despite these advances removal of these lesions remains a challenge. Methods. The results of the surgical treatment of PCF meningiomas wer e examined with the aim to identify particular features associated wit h increased mortality and morbidity. Results. Of 713 patients with men ingioma, 52 patients were identified with PCFM. Total macroscopic exci sion was achieved in 44 patients (84%). Postoperative complications oc curred in 28 patients (54%) with permanent sequelae in 18 (35%). There were no mortalities in the immediate postoperative period. Follow-up ranged from 14 to 174 months (mean 42), tumour has recurred in 11 pati ents (21%) with a long-term mortality of 11%. At their latest follow-u p 41 (79%) of patients achieved Glasgow outcome scores of 4 or 5. Conc lusions. Total excision of tumour should remain the goal of treatment in patients with PCFM. Despite the recent advances in preoperative pla nning and surgical techniques, the morbidity associated with surgery r emains significant. Notwithstanding, the majority of patients achieve a good outcome with surgical treatment.