Craniectomy Versus Craniotomy for Posterior Fossa Metastases: Complication Profile

Amir Hadanny, Uri Rozovski, Erez Nossek, Yuval Shapira, Ido Strauss, Andrew A. Kanner, Razi Sitt, Zvi Ram, Tal Shahar

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Objective Surgical resection of posterior fossa metastases (PFM) includes either suboccipital craniotomy or suboccipital craniectomy. The optimal surgical technique is yet to be defined. We examined the association between the chosen surgical approach and the occurrence of postoperative complications. Methods We retrospectively evaluated medical records and imaging characteristics of patients who underwent resection of newly diagnosed PFM between 2003 and 2014 in our medical center to identify covariates that significantly affected postoperative complications. Results Of 917 patients with brain metastases, 88 patients underwent surgery for PFM and were included in the study. Craniectomy was performed in 54 cases (61%). Urgent postoperative posterior fossa decompression or cerebrospinal fluid diversion was performed in 4 patients (4.5%). Postoperative complications included postoperative central nervous system infection (n = 10 [12%]), cerebrospinal fluid leak (n = 3 [4%]), wound dehiscence (n = 6 [7%]), and long-term pseudomeningocele (n = 12 [14%]). The perioperative mortality rate was 2.3% (n = 2). Multivariate analysis that included patient baseline characteristics, imaging study parameters, and surgical approaches demonstrated that suboccipital craniectomy was associated with more postoperative complications (P = 0.03, odds ratio = 4.48, 95% confidence interval = 1.14-17.6). There was no correlation between patient baseline characteristics or surgical technique with the need for urgent postoperative posterior fossa decompression or cerebrospinal fluid diversion. Conclusions Suboccipital craniotomy may be associated with a lower incidence of postoperative morbidity compared with suboccipital craniectomy and should be considered as the preferred approach for the resection of PFM.

Original languageEnglish
Pages (from-to)193-198
Number of pages6
JournalWorld Neurosurgery
StatePublished - May 2016
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2016 Elsevier Inc. All rights reserved.


  • Complications
  • Craniectomy
  • Craniotomy
  • Key words Brain metastases
  • Posterior fossa
  • Suboccipital


Dive into the research topics of 'Craniectomy Versus Craniotomy for Posterior Fossa Metastases: Complication Profile'. Together they form a unique fingerprint.

Cite this