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A Known complication of posterior fossa tumor rarely encountered-reverse coning

Posterior fossa tumors commonly present with obstructive hydrocephalus. Cerebrospinal fluid diversion procedures, done in such patients, carry the rare risk of reverse brain herniation, which is associated with significant mortality. The following case illustrates the need for the prompt diagnosis of reverse coning and immediate interruption of the ventriculoperitoneal shunt for patients who deteriorate after the procedure.