Migrating pseudomeningocele causing posterior fossa syndrome

We present two cases of spontaneous intracerebellar migration of a pseudomeningocele. This is a rarely reported complication of posterior fossa surgery with possible life threatening cerebellar mass effect. The probable mechanism is a slow but progressive cerebrospinal fluid (CSF) movement (one-way valve mechanism) into the pseudomeningocele with secondary herniation or dissection through a weakened dura into the cerebellum causing progressive or acute cerebellar dysfunction. Evacuation and dural repair with or without CSF shunting or marsupialisation results in resolution of the symptoms.