title: Retrograde third ventriculocisternostomy from the posterior fossa.
abstract: BACKGROUND
  Postoperative hydrocephalus is common in patients after resection of a posterior fossa tumor, with as many as 25% of patients requiring permanent cerebrospinal fluid diversion in the form of ventricular shunting or ventriculocisternostomy in some series. Prophylactic ventriculocisternostomy has been described with success in this patient population to prevent postoperative hydrocephalus.
  
  
  OBJECTIVE
  To define the technique of microsurgical retrograde third ventriculostomy from the posterior fossa.
  
  
  METHODS
  The operative technique is described and a single patient with 4-year follow-up is reported.
  
  
  RESULTS
  We describe the case of a 32-year-old woman who presented with a large cerebellopontine angle epidermoid tumor. She underwent a simultaneous lesion resection and third ventriculocisternostomy by accessing the interpeduncular cistern via a suboccipital posterior fossa approach and then making an incision through the tuber cinereum to access the third ventricle under direct vision.
  
  
  CONCLUSIONS
  Retrograde third ventriculostomy may be useful in the surgical treatment of patients already undergoing operations for large posterior fossa lesions who have a high likelihood of requiring permanent cerebrospinal fluid diversion and in whom exposure of the interpeduncular cistern is available.
authors.affiliation: Neurosurgical Service, Massachusetts General Hospital, Department of Surgery Neurosurgery, Harvard Medical School, Boston, Massachusetts 02114, USA.
authors.forename: Vijay
authors.initials: V
authors.lastname: Yanamadala
authors.forename: Brian P
authors.initials: BP
authors.lastname: Walcott
authors.forename: Brian V
authors.initials: BV
authors.lastname: Nahed
authors.forename: Fred G
authors.initials: FG
authors.lastname: Barker
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000517:prevention & control; D009464:Neuroma, Acoustic / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control; D014696:Ventriculostomy / Q000379:methods*