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Forum Name: Neurology Topics

Question: seroma after craniotomy


 casche53 - Sat Jul 31, 2010 3:07 pm

I had a 3.5 cm meningoma in the posterior fossa. It was removed in 12/09. One surgeon said the brain was "squished". In Feb. '10, I began getting headaches. An MRI showed a pocket of fluid. Neuro surgeon said it would disipate (sp?). By June '10, the headaches are more frequent, more intense and over a larger part of the head. A new MRI says the pocket of fluid, either a seroma or localised pocket of CSF fluid is present. It measures 2.3 cm x 0.9 cm. The neuro surgeon said this was OK, not related to the surgery and go see a neurologist for the symptoms. I can't even get an appt. to talk to him until Oct 1, '10.
Is this normal, If the tumor pressed on the brain, wouldn't a 2.3 cm pocket of fluid be pressing?, What treatment options are there?
 Dr.M.Aroon kamath - Mon Aug 16, 2010 12:55 am

User avatar Hi,
Extraaxial fluid collections following posterior cranial fossa surgery are well known.Based on CT imaging (Hounsfield intensities), they may be,
- collections with cerebrospinal fluid (CSF) intensity,
- collections containing mixtures of blood and CSF,or
- collections with blood intensity.


Often they are accompanied by the presence of persistent 'membrane enhancement' in their vicinity.

Some of them may enlarge and cause symptoms, while others may resolve spontaneously or remain static.

Generally, those that are asymptomatic will be observed and the symptomatic ones drained.

In your case, a thorough clinical examination by your neurologist and imaging would clarify if the lesion is causing pressure symptoms. Apart form the dimensions of the intracranial 'cystic' lesions, there may be other factors such as 'tenseness', rate of increase in size and the exact location which modify their potential to cause pressure effects.
Best wishes!

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