Superficial siderosis of the central nervous system associated with incomplete dural closure following posterior fossa surgery: report of 3 cases

J Neurosurg. 2015 Nov;123(5):1326-30. doi: 10.3171/2014.12.JNS141920. Epub 2015 Jun 12.

Abstract

This report reviews a series of 3 patients who developed superficial siderosis following posterior fossa operations in which dural closure was incomplete. In all 3 patients, revision surgery and complete duraplasty was performed to halt the progression of superficial siderosis. Following surgery, 2 patients experienced resolution of their CSF xanthochromia while 1 patient had reduced CSF xanthochromia. In this paper the authors also review the etiology, pathophysiology, diagnosis, and treatment of this condition. The authors suggest that posterior fossa dural patency and pseudomeningocele are risk factors for the latent development of superficial siderosis and recommend that revision duraplasty be performed in patients with posterior fossa pseudomeningoceles and superficial siderosis to prevent progression of the disease.

Keywords: PTA = pure tone average; RBC = red blood cell; VP = ventriculoperitoneal; WRS = word recognition score; posterior fossa; pseudomeningocele; sensorineural hearing loss; superficial siderosis.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Arnold-Chiari Malformation / surgery
  • Brain Neoplasms / surgery
  • Central Nervous System Diseases / cerebrospinal fluid
  • Central Nervous System Diseases / etiology*
  • Cranial Fossa, Posterior / surgery*
  • Disease Progression
  • Dura Mater / surgery*
  • Female
  • Glioma / surgery
  • Humans
  • Hydrocephalus / surgery
  • Male
  • Meningocele / surgery
  • Middle Aged
  • Neurosurgical Procedures / adverse effects*
  • Postoperative Complications / etiology*
  • Retrospective Studies
  • Risk Factors
  • Siderosis / cerebrospinal fluid
  • Siderosis / etiology*