What is a posterior fossa craniotomy?

A posterior fossa craniotomy is a surgical procedure that involves the removal of a brain tumour located in the posterior fossa. The posterior fossa is a small space in the bottom of the skull near the brainstem and cerebellum. The cerebellum’s function is to coordinate movements and balance. The brainstem is responsible for controlling the body’s vital functions such as breathing.

The development of a tumour in the posterior fossa may block the flow of cerebrospinal fluid and increase the risk of pressure in the brain and spinal cord. Posterior fossa tumours may cause symptoms such as headache, imbalance, uncoordinated walk, drowsiness and nausea, which may be accompanied by vomiting.

When is a posterior fossa craniotomy needed?

Posterior fossa craniotomy may be recommended if you are experiencing posterior fossa tumour symptoms and conservative treatments such as watching and monitoring with MRI scans have failed to relieve symptoms and treat the condition. The main goal of a posterior fossa craniotomy is to remove the tumour and relieve the pressure on the cerebellum, brain stem and spinal cord.

What does a posterior fossa craniotomy entail?

Posterior fossa craniotomy is performed under general anaesthesia. The hair above the location of the tumour will be shaved off, and the scalp will be cleaned. The neurosurgeon will make an incision on the scalp to access the skull. He will then remove a portion of the skull to gain access to the brain.  Surgical instruments will be passed through the opening, and the tumour will be resected. 

Midline posterior fossa tumours are normally removed with a midline suboccipital craniotomy. This procedure involves the neurosurgeon making an incision along the midline avascular plane at the back of your head. A drill is then used to create an opening on the foramen magnum and surgical instruments are then passed through the opening. The tumours will then be resected. A catheter may be inserted to drain excess cerebrospinal fluid which will then relieve pressure on the brain. After the procedure, the surgical instruments will be removed. The piece of the skull will be put back in place, and the stitches will be stitched closed.