Consensus guidelines for the management of posterior fossa tumour for low- and middle-income countries

Abstract

The posterior fossa is a limited compartment therefore
lesions compressing its structures can result in
devastating outcomes. It can cause significant
neurological deficit due to mass effect on critical
structures and hydrocephalus. Due to the nature of the
infratentorial region, urgent surgical intervention is often
the first-line option. Surgical neuro-oncologists guide
patients and caregivers through the course of this disease
and to inform them about the various options for
management and long-term outcome optimisation.
There is currently conflicting data; however, institutional
experiences can guide us towards achieving
improvements in surgical outcomes and quality of life.
Advances in molecular classifications coupled with highdose
radiation treatment improve our capacity for
improving overall survival in these patients. Common
childhood tumours are ependymomas,
medulloblastomas, and juvenile pilocytic astrocytomas,
while adults often present with metastases, and less
commonly, cerebellar haemangioblastomas and gliomas.
This paper outlines management strategies with
consideration for multidisciplinary care and resourcelimited
settings.
Keywords: Cerebellar neoplasms, medulloblastoma,
caregivers, hemangioblastoma, astrocytoma,
ependymoma, hydrocephalus, neuro-oncology,
neurosurgery, brain tumour, posterior fossa.