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Cerebellar Mutism Syndrome following Midline Posterior Fossa Tumor Resection in Children: An Institutional Experience

AIM: Cerebellar mutism (CM) syndrome is a well-known and annoying complication of posterior fossa surgery in the pediatric age group. Risk factors such as the type of tumor, size, involvement of posterior fossa structures and hydrocephalus, and postoperative cerebellar swelling for CM were investiga...

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Autores principales: Gora, Nand Kishore, Gupta, Ashok, Sinha, Virendra Deo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5890549/
https://www.ncbi.nlm.nih.gov/pubmed/29675068
http://dx.doi.org/10.4103/jpn.JPN_23_17
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author Gora, Nand Kishore
Gupta, Ashok
Sinha, Virendra Deo
author_facet Gora, Nand Kishore
Gupta, Ashok
Sinha, Virendra Deo
author_sort Gora, Nand Kishore
collection PubMed
description AIM: Cerebellar mutism (CM) syndrome is a well-known and annoying complication of posterior fossa surgery in the pediatric age group. Risk factors such as the type of tumor, size, involvement of posterior fossa structures and hydrocephalus, and postoperative cerebellar swelling for CM were investigated in this study. MATERIALS AND METHODS: A consecutive series of 33 children with midline posterior fossa tumors were operated at the SMS Medical College and Hospital, Department of Neurosurgery, Jaipur India, between September 2015 and December 2016. Their speech and neuroradiological studies were systematically analyzed both preoperatively and postoperatively. RESULTS: CM syndrome (CMS) developed in six children (18.18%) in the early postoperative period. The pre- and post-operative irritability, medulloblastoma histology, maximum size more than 45 mm, involvement of superior cerebellar peduncles, and vermian incision were significant single independent risk factors. In addition, male gender also associated with a higher risk for CMS. The latency for the development of mutism ranged from 1 to 12 days (mean 3.5 days). The speech returned to normal in all patients. All cases with CMS accompanied by cerebellar ataxia. CONCLUSION: The medulloblastoma, irritability, maximum size more than 45 mm, involvement of superior cerebellar peduncles, and vermian incision were significant single independent risk factors for postoperative pediatric CMS. Mutism after posterior fossa tumor resection is also accompanied with ataxia. CM usually has a self-limiting course and a favorable prognosis.
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spelling pubmed-58905492018-04-19 Cerebellar Mutism Syndrome following Midline Posterior Fossa Tumor Resection in Children: An Institutional Experience Gora, Nand Kishore Gupta, Ashok Sinha, Virendra Deo J Pediatr Neurosci Original Article AIM: Cerebellar mutism (CM) syndrome is a well-known and annoying complication of posterior fossa surgery in the pediatric age group. Risk factors such as the type of tumor, size, involvement of posterior fossa structures and hydrocephalus, and postoperative cerebellar swelling for CM were investigated in this study. MATERIALS AND METHODS: A consecutive series of 33 children with midline posterior fossa tumors were operated at the SMS Medical College and Hospital, Department of Neurosurgery, Jaipur India, between September 2015 and December 2016. Their speech and neuroradiological studies were systematically analyzed both preoperatively and postoperatively. RESULTS: CM syndrome (CMS) developed in six children (18.18%) in the early postoperative period. The pre- and post-operative irritability, medulloblastoma histology, maximum size more than 45 mm, involvement of superior cerebellar peduncles, and vermian incision were significant single independent risk factors. In addition, male gender also associated with a higher risk for CMS. The latency for the development of mutism ranged from 1 to 12 days (mean 3.5 days). The speech returned to normal in all patients. All cases with CMS accompanied by cerebellar ataxia. CONCLUSION: The medulloblastoma, irritability, maximum size more than 45 mm, involvement of superior cerebellar peduncles, and vermian incision were significant single independent risk factors for postoperative pediatric CMS. Mutism after posterior fossa tumor resection is also accompanied with ataxia. CM usually has a self-limiting course and a favorable prognosis. Medknow Publications & Media Pvt Ltd 2017 /pmc/articles/PMC5890549/ /pubmed/29675068 http://dx.doi.org/10.4103/jpn.JPN_23_17 Text en Copyright: © 2018 Journal of Pediatric Neurosciences http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Gora, Nand Kishore
Gupta, Ashok
Sinha, Virendra Deo
Cerebellar Mutism Syndrome following Midline Posterior Fossa Tumor Resection in Children: An Institutional Experience
title Cerebellar Mutism Syndrome following Midline Posterior Fossa Tumor Resection in Children: An Institutional Experience
title_full Cerebellar Mutism Syndrome following Midline Posterior Fossa Tumor Resection in Children: An Institutional Experience
title_fullStr Cerebellar Mutism Syndrome following Midline Posterior Fossa Tumor Resection in Children: An Institutional Experience
title_full_unstemmed Cerebellar Mutism Syndrome following Midline Posterior Fossa Tumor Resection in Children: An Institutional Experience
title_short Cerebellar Mutism Syndrome following Midline Posterior Fossa Tumor Resection in Children: An Institutional Experience
title_sort cerebellar mutism syndrome following midline posterior fossa tumor resection in children: an institutional experience
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5890549/
https://www.ncbi.nlm.nih.gov/pubmed/29675068
http://dx.doi.org/10.4103/jpn.JPN_23_17
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