title: Posterior fossa meningiomas: surgical experience in 52 cases.
abstract: BACKGROUND
  Early reports of the surgical management of posterior cranial fossa meningiomas (PCFM) yielded poor results with high rates of mortality and morbidity. With the advent of modern neuroimaging and microsurgical techniques the results of surgery have improved markedly, but despite these advances removal of these lesions remains a challenge.
  
  
  METHODS
  The results of the surgical treatment of PCF meningiomas were examined with the aim to identify particular features associated with increased mortality and morbidity.
  
  
  RESULTS
  Of 713 patients with meningioma, 52 patients were identified with PCFM. Total macroscopic excision was achieved in 44 patients (84%). Postoperative complications occurred 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 patients (21%) with a long-term mortality of 11%. At their latest follow-up 41 (79%) of patients achieved Glasgow outcome scores of 4 or 5.
  
  
  CONCLUSIONS
  Total excision of tumour should remain the goal of treatment in patients with PCFM. Despite the recent advances in preoperative planning and surgical techniques, the morbidity associated with surgery remains significant. Notwithstanding, the majority of patients achieve a good outcome with surgical treatment.
authors.affiliation: Department of Neurosurgery, St George's Hospital Medical School, Atkinson Morley's Hospital, London.
authors.forename: S A
authors.initials: SA
authors.lastname: Cudlip
authors.forename: P R
authors.initials: PR
authors.lastname: Wilkins
authors.forename: F G
authors.initials: FG
authors.lastname: Johnston
authors.forename: A J
authors.initials: AJ
authors.lastname: Moore
authors.forename: H T
authors.initials: HT
authors.lastname: Marsh
authors.forename: B A
authors.initials: BA
authors.lastname: Bell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003388:Cranial Fossa, Posterior; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008579:Meningioma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery; D012086:Reoperation; D015996:Survival Rate