CC BY-NC-ND 4.0 · Indian Journal of Neurosurgery 2018; 07(03): 223-226
DOI: 10.1055/s-0037-1602751
Case Report
Neurological Surgeons' Society of India

“Drowning Brain in a Pool of CSF” — A Rare Complication of Periencephalic Subdural Panhygroma following Removal of a Posterior Fossa Tumor

Bikash Ranjan Behera
1   Department of Neurosurgery, SCB Medical College, Cuttack, India
Ram Chandra Deo
1   Department of Neurosurgery, SCB Medical College, Cuttack, India
Sanjib Mishra
1   Department of Neurosurgery, SCB Medical College, Cuttack, India
Jyotirmayee Biswal
2   Peerless Hospital, Kolkata, West Bengal, India
Deepak Das
1   Department of Neurosurgery, SCB Medical College, Cuttack, India
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Received: 06. August 2016

accepted: 07. Februar 2017

12. Oktober 2017 (online)


Posterior fossa tumors are commonly encountered in pediatric age group patients. Most of these tumors present with features of hydrocephalus in the child. Conventionally, these cases are managed by suboccipital craniotomy with decompression of the tumor mass to establish the free flow of cerebrospinal fluid (CSF) across fourth ventricle and aqueduct of Sylvius. Following resection of posterior fossa tumor, appearance of subdural hygroma is a rare phenomenon.

Though few cases of subdural hygroma are reported in literature following foramen magnum decompression in Chiari's malformation, their appearance following posterior fossa tumor resection is alien to medical literature and limited to only two case reports. Here the authors present a patient with periencephalic subdural panhygroma (PSP) following posterior fossa tumor resection who was successfully treated with a ventriculoperitoneal shunt (VPS) to accomplish a symptomatic and radiologic remission.

  • References

  • 1 Elton S, Tubbs RS, Wellons III JC, Blount JP, Grabb PA, Oakes WJ. Acute hydrocephalus following a Chiari I decompression. Pediatr Neurosurg 2002; 36 (02) 101-104
  • 2 Bahl A, Murphy M, Thomas N, Gullan R. Management of infratentorial subdural hygroma complicating foramen magnum decompression: a report of three cases. Acta Neurochir (Wien) 2011; 153 (05) 1123-1128
  • 3 Oomman A, Rajalingam V. Subdural hygroma following posterior fossa tumor resection. Arch Int Surg 2014; 4: 193-199
  • 4 Payr E. Meningitis serosa bei und nach Schädelverletzungen (traumatica). Med Klin 1916; 12: 841-846
  • 5 Caldarelli M, Di Rocco C, Romani R. Surgical treatment of chronic subdural hygromas in infants and children. Acta Neurochir (Wien) 2002; 144 (06) 581-588 discussion 588
  • 6 Mizoi K, Takaku A, Suzuki J. Subdural effusion following radical surgery for chiasmal region tumors in children. Report of 4 cases. Childs Brain 1981; 8 (04) 307-315
  • 7 Ranjan A, Cast IP. Symptomatic subdural hygroma as a complication of foramen magnum decompression for hindbrain herniation (Arnold-Chiari deformity). Br J Neurosurg 1996; 10 (03) 301-303
  • 8 Morota N, Sakamoto K, Kobayashi N, Kitazawa K, Kobayashi S. Infantile subdural fluid collection: diagnosis and postoperative course. Childs Nerv Syst 1995; 11 (08) 459-466
  • 9 Forman PM, Chipps BE, Meyer GA. Managing chronic subdural hematomas and effusions in infants: a continuing dilemma. Tex Med 1974; 70 (04) 62-66
  • 10 Litofsky NS, Raffel C, McComb JG. Management of symptomatic chronic extra-axial fluid collections in pediatric patients. Neurosurgery 1992; 31 (03) 445-450
  • 11 Albuquerque FC, Giannotta SL. Arachnoid cyst rupture producing subdural hygroma and intracranial hypertension: case reports. Neurosurgery 1997; 41 (04) 951-955 discussion 955–956
  • 12 Marshman LA, Benjamin JC, Chawda SJ, David KM. Acute obstructive hydrocephalus associated with infratentorial subdural hygromas complicating Chiari malformation Type I decompression. Report of two cases and literature review. J Neurosurg 2005; 103 (04) 752-755
  • 13 Stavrinos NG, Taylor R, Rowe A, Whittle IR. Posterior fossa surgery complicated by a pseudomeningocele, bilateral subdural hygromata and cerebellar cognitive affective syndrome. Br J Neurosurg 2008; 22 (01) 107-109
  • 14 Filis AK, Moon K, Cohen AR. Symptomatic Subdural Hygroma and Hydrocephalus following Chiari I Decompression. Pediatr Neurosurg 2009; 45 (06) 425-428
  • 15 Suzuki F, Kitagawa T, Nozaki K, Takagi K. Subacute subdural hygroma and presyrinx formation after foramen magnum decompression with duraplasty for Chiari type 1 malformation. Neurol Med Chir (Tokyo) 2011; 51 (05) 389-393
  • 16 Bahuleyan B, Menon G, Hariharan E, Sharma M, Nair S. Symptomatic posterior fossa and supratentorial subdural hygromas as a rare complication following foramen magnum decompression for Chiari malformation Type I. J Neurosurg 2011; 114 (02) 510-513