This book, dedicated to the surgery of the posterior fossa, is an important effort to clearly and concisely present this anatomical region in its entireness, with a particular focus given to neurosurgical considerations. The underlying notion conveyed is that the posterior fossa’s unique anatomy and vital contents should be borne in mind while addressing the neurosurgical pathology in this region, and that management may differ significantly from that of supratentorial lesions. The principle author quotes Harvey Cushing when he states that surgery of the posterior fossa—coined by the latter as the “gloomy corner”—has consequently become less “gloomy”.

The book is divided into 25 chapters, grouped into four sections (General Considerations, Disease-Based Management, Surgical Techniques, Miscellaneous). The incentive of creating a concise, organized, and complete textbook on neurological surgery of the posterior fossa initially causes some redundancy between chapters in the first two sections. The Surgical Techniques section, however, is presented with a clear, fluid, organized structure, reproducible from chapter to chapter: general considerations, preoperative management, description of the surgical approach, indications, disadvantages, and complications of each surgical approach are sequentially (and equally well) addressed. The chapters are short and yet instructive and well documented, and a clear effort was made from the 47 contributing authors in presenting the essentials of posterior fossa surgery in a single textbook. The text is richly illustrated with explanatory and didactic images, although the second chapter dedicated to the Microsurgical Anatomy of the Posterior Cranial Fossa should be read with a neuroanatomy atlas at hand if the reader is not yet at ease with the complex regional anatomy.

Among minor remarks, a couple of figures are wrongly directed from the text, namely in the second and eleventh chapters (Microsurgical Anatomy of the Posterior Cranial Fossa and Basic Concepts in Posterior Fossa Surgery, respectively); Facial reanimation, e.g., hypoglossal-facial anastomosis, is also mentioned as a useful adjunct when function fails to return to the facial nerve, and this rare procedure is outlined in an illustrative manner. Finally, Battle’s sign—post-traumatic ecchymosis surrounding the mastoid process—is wrongly defined at one point in the text as bloody otorrhea.

In conclusion, Principles of Posterior Fossa Surgery is an instructive and helpful textbook for neurosurgery residents and fellows who are beginning to operate on the posterior fossa, giving both essential general information and interesting tips and details on surgical approaches and neurosurgical pathologies in this region of the skull and brain. Rarer entities are covered as well, rendering the book equally interesting for experienced neurosurgeons.