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A single-institution cohort of 92 consecutive pediatric patients harboring tumors involving the fourth ventricle, surgically treated the telovelar or transvermian approach, was retrospectively reviewed in order to analyze the impact of surgical route on surgery-related outcomes and cumulative survival. Clinical, radiological, surgical, and pathology details were retrospectively analyzed. We selected n = 6 surgery-related clinical and radiological outcomes transient and permanent neurological deficits, duration of assisted ventilation, po