215follow-up was 1.8, whereas the mean score at the
time of discharge was 2.6.
Microsurgical resection of cerebellar cavern-
ous malformations is associated with good out-
comes in the majority of cases. Because cerebellar
cavernous malformations are often grouped with
cavernous malformations in the brainstem, a few
reports have looked at the outcome of these
lesions independent of others in the posterior
fossa. Wu et al. [ 151 ] recently reported a series of
58 patients with cerebellar cavernous malforma-
tions treated using microsurgery. They found that
complete resection could be achieved in every
case and that the mean postoperative modified
Rankin Scale score was 0.5.
Conclusions
Despite advances in endovascular techniques and
chemoradiotherapy, many lesions in the posterior
fossa are best treated by microsurgery. Continued
developments in interventional tools and tech-
niques, as well as better chemotherapeutic, radio-
surgical, and radiotherapy regimens, are likely to
continue to help shrink lesions in the posterior
fossa so that they may be treated using open sur-
gery. However, for the foreseeable future, contin-
ued training in microsurgery in this confined
space is necessary and essential.
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14 Microsurgical Management of Posterior Fossa Vascular Lesions