Objective    To summarize the experience during the management of cerebrospinal fluid (CSF) leak and pseudomeningocele after posterior fossa surgery.     Methods    During a seven-year period (Jan 2000 to Jan 2007)

the clinical course of 23 patients suffered from CSF leak and pseudomeningocele after posterior fossa craniotomy at Daping Hospital were reviewed.     Results    Overall results were quite satisfactory. Four patients recovered after repeated subcutaneous punctures and pressure dressing. CSF leaks were stopped in seven patients by closed lumbar subarachnoid drainage. Twelve patients underwent repeated surgical repair of their leaks. No patients suffered ongoing or recurrent leakage after reoperation. The application of these management resulted in a total absence of CSF leaks and pseudomeningocele in 113 consecutive patients thereafter.     Conclusion    A watertight dural closure verified by Valsalva maneuver

with the addition of muscle pieces and tissue glue in a “plugging” fashion

provides a simple and effective technique for the prevention of CSF leakage or pseudomeningocele after posterior fossa surgery.