Anatomy of the posterior Fossa: a comprehensive description for pediatric brain tumors

Childs Nerv Syst. 2024 Mar;40(3):613-624. doi: 10.1007/s00381-023-06220-8. Epub 2023 Nov 24.

Abstract

Posterior fossa tumors are the most common pediatric brain tumors, and present unique challenges in terms of their location and surgical management. The posterior fossa comprehends complex anatomy and represents the smallest and deepest of the three cranial base fossae. An in-depth understanding of posterior fossa anatomy is crucial when it comes to the surgical resection of pediatric brain tumors. Mastering the knowledge of posterior fossa anatomy helps the neurosurgeon in achieving a maximal and safe volumetric resection, that impacts in both overall and progression free survival. With the advancements in microsurgery, the telovelar approach has emerged as the workhorse technique for the resection of posterior fossa tumors in pediatric patients. This approach involves meticulously dissecting of the natural clefts present in the cerebellomedullary fissure, making a comprehensive understanding of the underlying anatomy key for its success.

Keywords: Cerebellar tumor; Cerebellomedullary fissure; Cerebellum; Fourth ventricle; Neuroanatomy; Posterior fossa.

Publication types

  • Review

MeSH terms

  • Brain Neoplasms* / diagnostic imaging
  • Brain Neoplasms* / surgery
  • Cerebral Ventricle Neoplasms* / surgery
  • Child
  • Humans
  • Infratentorial Neoplasms* / diagnostic imaging
  • Infratentorial Neoplasms* / surgery
  • Microsurgery / methods
  • Neurosurgical Procedures / methods