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Background: Diverse tumors in the posterior third ventricular region (TPTVR) frequently occur in children. A decade's experience with pediatric TPTVR is presented, focusing on the Indian perspective. Materials and Methods: 25 children (age range: 3-18 years; mean age: 13.32 years; presentation range: 7 days-2.5 years) had clinico-radiological assessment with contrast computed tomography (CT) and magnetic resonance imaging (MRI). The ventricular/lumbar cerebrospinal fluid (CSF) alpha feto protein (AFP)/beta human chorionic gonadotrophin (HCG) estimation was done when radiological suspicion of a germ cell tumor was present. Extent of resection was deemed partial when some tumor mass remained at the end of surgery, near total when

Vestibular schwannomas (VSs) are rarer in children than in adults and are often associated with neurofibromatosis 2 (NF2). We focus on characteristic presentations of VSs in children ( 4 cm. Surgery was done in the park-bench position using the suboccipital retromastoid approach. Results: Raised intracranial pressure (ICP), often with visual deterioration, was the most commonly found presentation. Preoperative VIIth nerve involvement was grade IV in three, III in two and II in two patients. One of the patients with NF2 with proptosis did not have any VIIth nerve deficit. None of the patients had any functionally useful hearing on the side of larger tumor. Tumors were giant in six and large in two patients. In NF2 patients, two patients had large, two had medium-sized and one patient had a small contralateral tumor. Seven patients had significant hydrocephalus out of which three underwent ventriculoperitoneal shunt. Total excision of the larger lesion was performed in six patients. A small tumor remnant was left adherent to the preserved VIIth nerve in one patient. A patient with NF2 underwent excision of orbital neurofibroma and is awaiting surgery for VS. Two patients underwent bilateral VS excision. Anatomical preservation of the VIIth nerve was possible in six out of seven patients who underwent tumor excision. Postoperatively, symptoms of raised intracranial pressure and ataxia improved; visual deficits continued to deteriorate in two and VIIth nerve function deteriorated from grade III to V. Conclusions: In children, only a high degree of awareness facilitates early diagnosis of VS; otherwise, initial complaints may be neglected and the underlying tumor detected only after incapacitating raised ICP features appear. The retromastoid suboccipital approach is an effective approach for safe removal of large to giant-sized tumors.