Posterior Fossa Decompression

What is posterior fossa decompression?

Posterior fossa decompression, also known as suboccipital craniotomy, is a surgical procedure intended to relieve pressure around the brain and spinal cord. There are three cranial fossa in the brain– the anterior fossa, middle fossa, and the posterior fossa. Situated on the furthest rear of the brain, the posterior fossa houses parts of the brainstem and cerebellum. 

Cranial fossae
The posterior fossa is located at the lower end of the brain.

A posterior fossa decompression addresses conditions where a constriction at the brainstem and cerebellum is evident. This surgery also improves the circulation of cerebrospinal fluid (CSF), the fluid that protects and carries nutrients to the brain. 

The presentation of symptoms that may signal a requirement for posterior fossa decompression includes: 

  • Headaches 
  • Gait instability 
  • Drowsiness, which can be accompanied by nausea 
  • Generalised numbness and weakness 
  • Visual disturbances
  • Cognitive decline  
Migraine aura
Visual distortion caused by brain and spine conditions could justify a posterior fossa decompression procedure.

How does posterior fossa decompression work?

During the surgery, patients are sedated with general anaesthesia and then positioned face down to allow access to the lower skull region. An incision is made in the tissues at the back of the head and neck bones which cover the bottom of the brain. In order to remove constriction and relieve pressure, a small piece of bone, either from the bottom of your skull or the upper part of your spine, is removed. The incision is then closed with clips or sutures. 

Depending on the diagnosis, a variation in procedure may be employed. For example, removing the bottom of the cerebellum may be necessary. In other cases, a tumour resection or a blood clot removal may be required. The exact specification of the procedure will be informed before the surgery to ensure patients are necessarily informed. 

Chiari malformation
Posterior fossa decompression is a commonly employed treatment for Chiari malformation.

Benefits of posterior fossa decompression

  • Halts the progression of symptoms and neurological decline 
  • Restores metabolic and temporal regulation 
  • Reinforces the protective mechanism of the brain 
  • Provides an opportunity to regain cognitive performance 

What conditions can a posterior fossa decompression treat?

One may be relieved with a posterior fossa decompression procedure if diagnosed with:

If you have any of the conditions listed above, make an appointment with Chou Neuroscience Clinic for customised treatment.

What results can I expect after a posterior fossa decompression? 

Fundamentally, a posterior fossa decompression relieves pressure built up in the lower base of the skull and spine. Where abnormal growths are identified, these will be rectified during the surgery. 

Patients may also experience headaches, moderate amounts of neck pain, numbness, and fatigue after the surgery. However, patients can expect relief and alleviation from pre-surgery symptoms after recovery. 

The recovery of a patient post-surgery is relative to the brain condition and the underlying cause of symptom presentation. If signs of complications are present, your neurosurgeon will appropriately manage these. 

How many posterior fossa decompression sessions are needed? 

A posterior fossa decompression is usually a one-off procedure; however, treatment does not end at surgery. You will be monitored post-operation to ensure the stability of vital signs is established, and improvement of neurological functions is achieved with a series of neurological exams

Once you return home, your neurosurgeon may advise you to avoid strenuous activities for some time. You can expect regular follow-up appointments to monitor your progress and address concerns. You may also be paired with a physical therapist to regain cognitive and physical functions. 

Frequently asked questions  

What are the risks associated with posterior fossa decompression?

As with any surgery, there are risks that patients will be informed of beforehand. The likelihood of these occurring is generally rare in the hands of an expert neurosurgeon. Nevertheless, risks may include: 
-- Infection: which will be managed with antibiotics.
-- Vomiting or nausea: as your body adjusts to the recovery process.
-- Brain fluid leakage: would require further surgery and investigation.

How long does the surgery take?

The surgery typically takes 2-3 hours, but the time depends on the complexity of the case and the surgical techniques employed.

Can symptoms return after posterior fossa decompression surgery?

The surgery often provides long-term relief, but symptoms can sometimes recur. You can monitor your progress with your neurosurgeon to promptly address any issues.

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Copyright © 2023 Chou Neuroscience Clinic. All Rights Reserved
Copyright © 2023 Chou Neuroscience Clinic. All Rights Reserved