INCIDENCE OF PSEUDOMENINGOCELE IN CASES UNDERGOING POSTERIOR FOSSA SURGERY

Introduction: Pseudomeningocele is a common complication following posterior fossa surgery, characterized by an abnormal collection of cerebrospinal uid surrounded by extradural soft tissue. This study investigated the incidence of pseudomeningocele following posterior fossa surgery and analyzed associated risk factors. Methods: This prospective observational study included 100 patients who underwent intradural posterior fossa surgery at Osmania General Hospital, Hyderabad, between January 2023 and October 2024. Data collected included demographics, comorbidities, preoperative parameters (GCS, hemoglobin, albumin), surgical details (approach, type of dural closure), and postoperative outcomes. Statistical analysis was performed using SPSS version 26. Results:The mean age of patients was 27.3±20.7 years with a male-to-female ratio of 0.8:1. The most common lesions were cerebellopontine angle space-occupying lesions (26%), fourth ventricular tumors (15%), and cerebellar tumors (11%). Craniotomy was performed in 75% of cases and craniectomy in 25%. The overall incidence of pseudomeningocele was 17%. Patients with pseudomeningocele had lower mean albumin levels (3.62 g/dL) compared to those without (4.32 g/dL). Lower incidence of pseudomeningocele was observed in patients who had preoperative ventriculoperitoneal shunt placement (14.71%) compared to those without (18.18%). Autologous grafts were associated with a lower incidence of pseudomeningocele compared to primary closure or combined techniques. Conclusion: The incidence of pseudomeningocele following posterior fossa surgery was 17%. Preoperative optimization of nutritional status, performing craniotomies when possible, using autologous grafts for dural closure, and preoperative ventriculoperitoneal shunt placement in cases with hydrocephalus may help reduce the incidence of pseudomeningocele. Early intervention is recommended to minimize complications and morbidity