Background: The Posterior fossa meningiomas constitute about 15 to 20% of all types of intracranial meningiomas. They usually become large, while they start producing clinical symptoms, because of their slow and indolent growth. Even though the microsurgical excision is the mainstay of treatment, the tumors’s location, encroachment of adjacent neurovascular structures and it’s invasive behavior, the surgery still remains challenging. Material and Methods: This is a prospective clinical study of about 32 cases of posterior fossa meningiomas, operated at “ Institute of Neurosurgery, Rajiv Gandhi Government General Hospital & Madras Medical College, Chennai-3”during the period. The incidence, various surgical procedures, postoperative complications & outcome were analysed. Results: In about 72% of cases, Gross total resection was done. Subtotal excision was done in Petroclival, Jugular foramen with extra cranial extension, Tentorial meningiomas with sinus extension and ventrally placed foramen magnum tumors. Postoperative complications in the form of CSF leak was found in about 12.5% cases and new onset or aggravation of preexisting neurological deficit in about 33% of cases. We had encountered two recurrent cases over a mean follow up of 1 year. Conclusion: Because of its close proximity to the sinus and adjacent neurovascular structures, posterior fossa meningiomas are very difficult to excise. Judicious use of Microscope, CUSA, intra operative nerve monitor helps in preserving the significant anatomical substrates. The postoperative recovery occurs completely, even though the neurological deterioration is common.

Keywords: Posterior fossa meningioma; Gross total resection; Postoperative complications.