Large posterior fossa mass & severe hydrocephalus
Dr. John Honeycutt, Medical Director, Neuro-Trauma
Cook Children’s Medical Center Fort Worth, Texas
PATIENT INFO: 5 year-old female
SUMMARY: Surgeon noted more fullness of the cerebellum than expected following presumed gross total resection. Intraoprative MR imaging revealed a large left frontal epidural hematoma attributed to the pinion of the headrest. Although coil positioning was not optimal for frontal fossa detail during this posterior fossa case, visualization of the significant mass was possible.
The suboccipital wound was promptly closed and the patient repositioned, followed by a frontotemporal craniotomy for frontal clot evacuation. Two hours after discovery of the frontal epidural, both wounds had been closed. A subsequent intraoperative MRI showed absence of clot at both operative sites.
Gross total removal of tumor was confirmed and the patient’s recovery was uneventful.