One of the most common brain tumours is posterior fossa tumours which is the commonest site of primary intracranial tumours in paediatric age group .
In our study, we found that headache and vomiting were found to be the primary presenting symptoms in 90.9% and 77.3%, respectively, of patients with a posterior fossa tumour.
The study of Jiang et al., published in 2016 including 67 patients, found that the most common clinical presentation were symptoms of increased intracranial tension as nausea or vomiting (69%), headache (29%) and cerebellar dysfunction such as ataxia and diplopia in 45% and 3% of patients, respectively . In another study of 45 patients in 2016, the most common symptoms were headache (51%), nausea ± vomiting (36%) visual disturbance (18%), and gait disturbance (18%) .
We needed, in our study, to insert a V-P shunt in 30 cases (68.2%) either pre or post to tumour excision, and the shunts were revised in 8 cases (18.2%).
Robert et al. found that permanent cerebrospinal fluid diversion was needed in 33% of patients . In another study, V-P shunt was inserted in 53% of patients .
In our study, the surgical complications were haemorrhage in 13.6% of our cases which was resolved spontaneously without need for surgery, and lower cranial nerve palsy (bulbar) occurred in 9.1% of cases (three improved partially and the fourth need tracheotomy).
A study of Islam et al.  of 32 patients concluded that cerebrospinal fluid leakage was the most common complication which occurred in 26.7% of cases followed by pseudomeningocele in 23.5% of cases. In a study of Charles and Morgan , 121 patients had complication rate of 19% with a single case mortality. An uneventful postoperative period in 31% of cases and only 19% had neurological complications at long-term .
Astrocytoma was the most common pathology in our study, and a rare dermoid tumour was present in one case.
In 66 patients’ study, medulloblastoma (29.26%) and pilocytic astrocytoma (29.26%) were the common posterior fossa brain tumours . A case study was represented a rare intracranial dermoid tumour with its uncommon location in the posterior fossa .
In our study, excellent surgical outcome was observed in 12 cases (27.3%), good in 22 cases (50.0%), while poor outcome was observed in 10 cases (22.7%).
In Shaikh et al.’s study , 66 patients concluded the surgical outcome into good in 77% of their studied group while poor outcome (moderately disable, not to perform daily activities independently or have neurological deficit) in 23% .
In our study, the best outcome is astrocytoma then ependymoma while the worst outcome is metastatic then (poor 41.7%).
In other study, the best outcome was ependymoma in then astrocytoma. As in our study, the worst outcome was metastatic then medulloblastoma .
Recurrence in our study occurred in 9.1% of patients, 3 medulloblastoma and one ependymoma. Three patients died (6.8%).
Recurrence in Shaikh et al.’s study occurred in 8.33% of patients, 2 medulloblastoma. Two cases (4.87%) died . In another study, only one case mortality was detected, 0.83% . The latest study, 2018, had 6.7% death rate .