Department of Neurosurgery, The Aga Khan University, Karachi, Pakistan.
Department of Paediatric Oncology, The Aga Khan University, Karachi, Pakistan.
J Pak Med Assoc. 2024 Mar;74(3 (Supple-3)):S186-S190. doi: 10.47391/JPMA.S3.GNO-22.
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.
后颅窝是一个有限的腔隙，因此压迫其结构的病变可能导致严重的后果。由于对关键结构的占位效应和脑积水，它可能导致严重的神经功能缺损。由于小脑幕下区域的性质，紧急手术干预通常是首选。神经外科肿瘤医生指导患者和护理人员了解疾病的发展过程，并告知他们关于各种治疗方案和长期结果优化的选择。目前的数据存在冲突；然而，机构经验可以指导我们提高手术结果和生活质量。分子分类的进步加上大剂量放射治疗提高了我们改善这些患者总体生存率的能力。常见的儿童肿瘤是室管膜瘤、髓母细胞瘤和青少年毛细胞型星形细胞瘤，而成年人通常表现为转移，较少见的是小脑血管母细胞瘤和胶质瘤。本文概述了考虑多学科护理和资源有限环境的管理策略。
