The risk of hydrocephalus in posterior Table Cloth fossa tumour is quite high (71- 90%), cerebrospinal fluid (CSF) diversion procedures like ventriculoperitoneal (VP) shunt, Endoscopic third ventriculostomy (ETV) and external ventricular drainage (EVD) are emergency procedures and may improve symptoms like headache and vomiting.However, post-operative deterioration after CSF diversion should alert the clinician to the possibility of RBH which is rare (3%) and has a high mortality.We report a case of a 12-year female child with a left cerebellar lesion with hydrocephalus.VP shunt Handheld Vacuum Battery Charger was done and her pupils revert back to normal size, two hours post-surgery her pupils become dilated and not reacting to light, an urgent CT was done which showed reverse brain herniation.
Reverse brain herniation is a very rare complication after the CSF diversion procedure with a poor prognosis.