Brainstem Compression: a Predictor of Postoperative Cerebellar Mutism

Overview

Journal Childs Nerv Syst

Specialty Pediatrics

Date 2008 Dec 17

PMID 19082829

Citations 24

Authors

H J McMillan

D L Keene

M A Matzinger

M Vassilyadi

M Nzau

E C G Ventureyra

Affiliations

Soon will be listed here.

Abstract

Purpose: Cerebellar mutism is a common complication of posterior fossa tumor resection. We observed marked, preoperative brainstem compression on MR imaging, among patients who developed postoperative mutism. This study was designed to investigate if an association was indeed present.

Materials And Methods: Patients (18 months-18 years) undergoing resection of a midline, posterior fossa tumor were retrospectively reviewed. Demographic data, tumor pathology, mutism onset and duration, and postoperative complications were obtained from hospital records. Pre- and postoperative MR images were studied to assess tumor size and the severity of pons compression (an estimate of the mechanical and distortional forces imparted by the tumor).

Results: Patients with mutism showed greater preoperative pons compression and a greater increase in postoperative pons diameter.

Conclusion: We predict that brainstem compression may represent white-matter injury from (1) surgical manipulation and traction, and (2) axonal damage caused by the release of the tumor's compressive force and ensuing axon distortion and dysfunction. The results provide support that mutism may be largely caused by white-matter damage disrupted axon integrity and function.

Citing Articles

Neuroimaging of postoperative pediatric cerebellar mutism syndrome: a systematic review.

Obdeijn I, van Baarsen K, Avula S, Toescu S, Lequin M, Hoving E Neurooncol Adv. 2025; 7(1):vdae212.

PMID: 39777259 PMC: 11705075. DOI: 10.1093/noajnl/vdae212.

Cerebellar mutism syndrome caused by bilateral cerebellar hemorrhage in adults: a case report and review of the literature.

Zedde M, Grisendi I, Assenza F, Napoli M, Moratti C, Cecco G Neurol Sci. 2024; 45(9):4161-4171.

PMID: 38724752 DOI: 10.1007/s10072-024-07571-z.

Pediatric hemispheric cerebellar low-grade gliomas: clinical approach, diagnosis, and management challenges-experience at a tertiary care children's hospital.

Cicutti S, Del Rio R, Caceres A, Gonzalez Ramos J Childs Nerv Syst. 2024; 40(8):2321-2332.

PMID: 38607550 DOI: 10.1007/s00381-024-06394-9.

Diffusion Tensor Imaging Technique Delineating the Prognosis for Cerebellar Mutism in Posterior Fossa Tumors: A New Tool.

Sinha V, Ankur P, Gaurav J Acta Neurochir Suppl. 2023; 135:53-59.

PMID: 38153449 DOI: 10.1007/978-3-031-36084-8_10.

The Cerebellar Mutism Syndrome: Risk Assessment, Prevention and Treatment.

Gronbaek J, Boeg Thomsen D, Persson K, Mathiasen R, Juhler M Adv Tech Stand Neurosurg. 2023; 46:65-94.

PMID: 37318570 DOI: 10.1007/978-3-031-28202-7_4.

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