title: Superficial siderosis of the central nervous system associated with incomplete dural closure following posterior fossa surgery: report of 3 cases.
abstract: This report reviews a series of 3 patients who developed superficial siderosis following posterior fossa operations in which dural closure was incomplete. In all 3 patients, revision surgery and complete duraplasty was performed to halt the progression of superficial siderosis. Following surgery, 2 patients experienced resolution of their CSF xanthochromia while 1 patient had reduced CSF xanthochromia. In this paper the authors also review the etiology, pathophysiology, diagnosis, and treatment of this condition. The authors suggest that posterior fossa dural patency and pseudomeningocele are risk factors for the latent development of superficial siderosis and recommend that revision duraplasty be performed in patients with posterior fossa pseudomeningoceles and superficial siderosis to prevent progression of the disease.
authors.affiliation: Departments of 1 Neurosurgery.
authors.forename: Ravi
authors.initials: R
authors.lastname: Kumar
authors.affiliation: Departments of 1 Neurosurgery.
authors.forename: Jeffrey T
authors.initials: JT
authors.lastname: Jacob
authors.affiliation: Radiology, and.
authors.forename: Kirk M
authors.initials: KM
authors.lastname: Welker
authors.affiliation: Neurology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Fred M
authors.initials: FM
authors.lastname: Cutrer
authors.affiliation: Departments of 1 Neurosurgery.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Link
authors.affiliation: Departments of 1 Neurosurgery.
authors.forename: John L D
authors.initials: JL
authors.lastname: Atkinson
authors.affiliation: Departments of 1 Neurosurgery.
authors.forename: Nicholas M
authors.initials: NM
authors.lastname: Wetjen
mesh_terms: D000293:Adolescent; D000328:Adult; D001139:Arnold-Chiari Malformation / Q000601:surgery; D001932:Brain Neoplasms / Q000601:surgery; D002493:Central Nervous System Diseases / Q000134:cerebrospinal fluid / Q000209:etiology*; D003388:Cranial Fossa, Posterior / Q000601:surgery*; D018450:Disease Progression; D004388:Dura Mater / Q000601:surgery*; D005260:Female; D005910:Glioma / Q000601:surgery; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery; D008297:Male; D008588:Meningocele / Q000601:surgery; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012806:Siderosis / Q000134:cerebrospinal fluid / Q000209:etiology*
keywords: PTA = pure tone average; RBC = red blood cell; VP = ventriculoperitoneal; WRS = word recognition score; posterior fossa; pseudomeningocele; sensorineural hearing loss; superficial siderosis