scholarly journals B - 17Neuropsychological Recovery in a Pediatric Case of a Cerebellar Cognitive Affective Syndrome Status-Post Cerebellar Tumor Resection

2018 ◽  
Vol 33 (6) ◽  
pp. 703-794
Author(s):  
S Muslin ◽  
S Peery ◽  
H Aaron ◽  
J Burciaga ◽  
R Hirst
Keyword(s):  
Tumor Resection ◽  
Cerebellar Tumor ◽  
Cerebellar Cognitive Affective Syndrome ◽  
Pediatric Case

scholarly journals Pediatric postoperative cerebellar cognitive affective syndrome follows outflow pathway lesions

Neurology ◽  
2019 ◽  
Vol 93 (16) ◽  
pp. e1561-e1571 ◽  
Author(s):  
Fatimah M. Albazron ◽  
Joel Bruss ◽  
Robin M. Jones ◽  
Torunn I. Yock ◽  
Margaret B. Pulsifer ◽  
...  
Keyword(s):  
Tumor Resection ◽  
Lesion Volume ◽  
Cerebellar Tumor ◽  
Cerebellar Cognitive Affective Syndrome ◽  
Resting State Functional Connectivity ◽  
Mediodorsal Nucleus ◽  
Lesion Location ◽  
Lesion Symptom Mapping ◽  
Affective Disturbances ◽  
Outflow Pathway

ObjectiveTo evaluate lesion location after pediatric cerebellar tumor resection in relation to the development of severe cognitive and affective disturbances, or cerebellar cognitive affective syndrome (CCAS).MethodsThe postsurgical lesion location of 195 pediatric patients with cerebellar tumors was mapped onto a template brain. Individuals with CCAS were matched to 2 participants without CCAS by sex, age, and lesion volume. Lesion analyses included both a hypothesis-driven evaluation of the cerebellar outflow pathway (deep nuclei and superior cerebellar peduncles) and data-driven multivariate lesion symptom mapping. Lesion-associated networks were evaluated by comparing connectivity patterns between the lesion location of cases with and those without CCAS with resting-state functional connectivity MRI data from large normative adult and pediatric cohorts.ResultsCCAS was present in 48 of 195 participants (24.6%) and was strongly associated with cerebellar outflow tract lesions (p < 0.0001). Lesion symptom mapping also highlighted the cerebellar outflow pathway, with peak findings in the fastigial nuclei extending into the inferior vermis. Lesion network mapping revealed that the cerebellar region most associated with CCAS was functionally connected to the thalamic mediodorsal nucleus, among other sites, and that higher connectivity between lesion location and the mediodorsal nucleus predicts CCAS occurrence (p < 0.01). A secondary analysis of 27 participants with mutism revealed similar localization of lesions and lesion-associated networks.ConclusionLesions of the cerebellar outflow pathway and inferior vermis are associated with major cognitive and affective disturbances after pediatric cerebellar tumor resection, and disrupted communication between the cerebellum and the thalamic mediodorsal nucleus may be important.

Spine Metastasis of Thymic Carcinoma in a Pediatric Patient: A Case Report and Comprehensive Literature Review

2020 ◽  
Vol 55 (5) ◽  
pp. 289-294
Author(s):  
Kadir Oktay ◽  
Ebru Guzel ◽  
Okay Baykara ◽  
Mevlana Akbaba ◽  
Ibrahim Sari ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Thymic Carcinoma ◽  
Tumor Resection ◽  
Treatment Protocol ◽  
Spinal Column ◽  
Spinal Instability ◽  
Pediatric Case ◽  
Case Presentation ◽  
Intrathoracic Tumor ◽  
History Of

<b><i>Introduction:</i></b> Thymic carcinoma metastases of the spinal column are very rare, especially in pediatric patients. To our knowledge, this is the first such pediatric case in the literature. <b><i>Case Presentation:</i></b> We report the case of a 14-year-old male patient with T12 and L1 metastases of thymic carcinoma. He had history of thymectomy and intrathoracic tumor resection 7 months previously. The patient’s neurological condition deteriorated; therefore, tumor resection and decompression of the spinal canal were performed. He underwent instrumentation and fusion procedures to prevent spinal instability. <b><i>Conclusion:</i></b> The main purpose of the treatment is gross total resection of the thymic carcinoma. However, adjuvant methods such as radiotherapy and chemotherapy should be added to the treatment protocol in patients who have higher stage diseases or those in whom total tumor resection cannot be achieved.

scholarly journals Tractographic and Microstructural Analysis of the Dentato-Rubro-Thalamo-Cortical Tracts in Children Using Diffusion MRI

2020 ◽  
Author(s):  
Sebastian M Toescu ◽  
Patrick W Hales ◽  
Enrico Kaden ◽  
Luis M Lacerda ◽  
Kristian Aquilina ◽  
...  
Keyword(s):  
Diffusion Mri ◽  
Microstructural Analysis ◽  
Tumor Resection ◽  
Healthy Children ◽  
Cerebellar Tumor ◽  
Superior Cerebellar Peduncle ◽  
Spherical Deconvolution ◽  
Spherical Mean ◽  
Cerebellar Peduncle ◽  
Outflow Pathway

Abstract The dentato-rubro-thalamo-cortical tract (DRTC) is the main outflow pathway of the cerebellum, contributing to a finely balanced corticocerebellar loop involved in cognitive and sensorimotor functions. Damage to the DRTC has been implicated in cerebellar mutism syndrome seen in up to 25% of children after cerebellar tumor resection. Multi-shell diffusion MRI (dMRI) combined with quantitative constrained spherical deconvolution tractography and multi-compartment spherical mean technique modeling was used to explore the frontocerebellar connections and microstructural signature of the DRTC in 30 healthy children. The highest density of DRTC connections were to the precentral (M1) and superior frontal gyri (F1), and from cerebellar lobules I–IV and IX. The first evidence of a topographic organization of anterograde projections to the frontal cortex at the level of the superior cerebellar peduncle (SCP) is demonstrated, with streamlines terminating in F1 lying dorsomedially in the SCP compared to those terminating in M1. The orientation dispersion entropy of DRTC regions appears to exhibit greater contrast than that shown by fractional anisotropy. Analysis of a separate reproducibility cohort demonstrates good consistency in the dMRI metrics described. These novel anatomical insights into this well-studied pathway may prove to be of clinical relevance in the surgical resection of cerebellar tumors.

Supratentorial Arterial Ischemic Stroke following Cerebellar Tumor Resection in Two Children

2005 ◽  
Vol 41 (4) ◽  
pp. 206-211 ◽  
Author(s):  
Coriene E. Catsman-Berrevoets ◽  
Melanie van Breemen ◽  
Marie Lise van Veelen ◽  
Inge M. Appel ◽  
Maarten H. Lequin
Keyword(s):  
Ischemic Stroke ◽  
Tumor Resection ◽  
Cerebellar Tumor ◽  
Arterial Ischemic Stroke

scholarly journals Adaptation and aftereffects of split-belt walking in cerebellar lesion patients

2015 ◽  
Vol 114 (3) ◽  
pp. 1693-1704 ◽  
Author(s):  
Wouter Hoogkamer ◽  
Sjoerd M. Bruijn ◽  
Stefan Sunaert ◽  
Stephan P. Swinnen ◽  
Frank Van Calenbergh ◽  
...  
Keyword(s):  
Tumor Resection ◽  
Step Length ◽  
Gait Pattern ◽  
Control Group ◽  
Cerebellar Tumor ◽  
Healthy Controls ◽  
Focal Lesions ◽  
Gait Adaptation ◽  
Cerebellar Damage ◽  
Specific Localization

To walk efficiently and stably on different surfaces under various constrained conditions, humans need to adapt their gait pattern substantially. Although the mechanisms behind locomotor adaptation are still not fully understood, the cerebellum is thought to play an important role. In this study we aimed to address the specific localization of cerebellar involvement in split-belt adaptation by comparing performance in patients with stable focal lesions after cerebellar tumor resection and in healthy controls. We observed that changes in symmetry of those parameters that were most closely related to interlimb coordination (such as step length and relative double stance time) were similar between healthy controls and cerebellar patients during and after split-belt walking. In contrast, relative stance times (proportions of stance in the gait cycle) were more asymmetric for the patient group than for the control group during the early phase of the post-split-belt condition. Patients who walked with more asymmetric relative stance times were more likely to demonstrate lesions in vermal lobules VI and Crus II. These results confirm that deficits in gait adaptation vary with ataxia severity and between patients with different types of cerebellar damage.

scholarly journals Verbal Memory Impairments in Children after Cerebellar Tumor Resection

2008 ◽  
Vol 20 (1-2) ◽  
pp. 39-53 ◽  
Author(s):  
Matthew P. Kirschen ◽  
Mathew S. Davis-Ratner ◽  
Marnee W. Milner ◽  
S. H. Annabel Chen ◽  
Pam Schraedley-Desmond ◽  
...  
Keyword(s):  
Verbal Memory ◽  
Digit Span ◽  
Tumor Resection ◽  
Visual Stimuli ◽  
Verbal Working Memory ◽  
Phonological Similarity ◽  
Cerebellar Tumor ◽  
Memory Impairments ◽  
Mri Scans ◽  
Phonological Store

This study was designed to investigate cerebellar lobular contributions to specific cognitive deficits observed after cerebellar tumor resection. Verbal working memory (VWM) tasks were administered to children following surgical resection of cerebellar pilocytic astrocytomas and age-matched controls. Anatomical MRI scans were used to quantify the extent of cerebellar lobular damage from each patient's resection. Patients exhibited significantly reduced digit span for auditory but not visual stimuli, relative to controls, and damage to left hemispheral lobule VIII was significantly correlated with this deficit. Patients also showed reduced effects of articulatory suppression and this was correlated with damage to the vermis and hemispheral lobule IV/V bilaterally. Phonological similarity and recency effects did not differ overall between patients and controls, but outlier patients with abnormal phonological similarity effects to either auditory or visual stimuli were found to have damage to hemispheral lobule VIII/VIIB on the left and right, respectively. We postulate that damage to left hemispheral lobule VIII may interfere with encoding of auditory stimuli into the phonological store. These data corroborate neuroimaging studies showing focal cerebellar activation during VWM paradigms, and thereby allow us to predict with greater accuracy which specific neurocognitive processes will be affected by a cerebellar tumor resection.

Emotions and Their Cognitive Control in Children With Cerebellar Tumors

2010 ◽  
Vol 16 (6) ◽  
pp. 1027-1038 ◽  
Author(s):  
TALAR HOPYAN ◽  
SUZANNE LAUGHLIN ◽  
MAUREEN DENNIS
Keyword(s):  
Cognitive Control ◽  
Significant Interaction ◽  
Cerebellar Tumor ◽  
Cerebellar Cognitive Affective Syndrome ◽  
Identification Task ◽  
Emotion Identification ◽  
Cerebellar Lesions ◽  
Regulation Of Emotion ◽  
Emotions In Music

AbstractA constellation of deficits, termed the cerebellar cognitive affective syndrome (CCAS), has been reported following acquired cerebellar lesions. We studied emotion identification and the cognitive control of emotion in children treated for acquired tumors of the cerebellum. Participants were 37 children (7–16 years) treated for cerebellar tumors (19 benign astrocytomas (AST), 18 malignant medulloblastomas (MB), and 37 matched controls (CON). The Emotion Identification Task investigated recognition of happy and sad emotions in music. In two cognitive control tasks, we investigated whether children could identify emotion in situations in which the emotion in the music and the emotion in the lyrics was either congruent or incongruent. Children with cerebellar tumors identified emotion as accurately and quickly as controls (p > .05), although there was a significant interaction of emotions and group (p < .01), with the MB group performing less accurately identifying sad emotions, and both cerebellar tumor groups were impaired in the cognitive control of emotions (p < .01). The fact that childhood acquired cerebellar tumors disrupt cognitive control of emotion rather than emotion identification provides some support for a model of the CCAS as a disorder, not so much of emotion as of the regulation of emotion by cognition. (JINS, 2010, 16, 1027–1038.)

scholarly journals Constraint-induced movement therapy in a patient with ataxia after cerebellar tumor resection

2019 ◽  
Vol 32 ◽  
Author(s):  
Ada Cristina Silva da Silva ◽  
Dayanna Letícia Silva Santos ◽  
Suellen Alessandra Soares de Moraes
Keyword(s):  
Case Report ◽  
Tumor Resection ◽  
Movement Therapy ◽  
Modern Method ◽  
Functional Improvement ◽  
Cerebellar Tumor ◽  
Patient’S Satisfaction ◽  
Constraint Induced Movement Therapy ◽  
The Right ◽  
Speed Accuracy

Abstract Introduction: Constraint-induced movement therapy (CIMT) is a very modern method used in rehabilitation to treat individuals with functional impairment of the upper limbs. Objective: To apply the CIMT method and evaluate its effects in a patient with ataxia after removal of a cerebellar tumor. Method: This is a longitudinal interventional study of the case report type. The participant complained of tremors and difficulty writing and typing with the right hand as a result of the cerebellar tumor’s removal. She was subjected to CIMT daily in three-hour sessions for 10 days. The participant was evaluated with the Motor Activity Log (MAL) and the Wolf Motor Function Test (WMFT). Results: There was an improvement in the quantity, quality, speed, accuracy and strength with which the participant performed the tasks according to the MAL and WMFT scales. Improvement in writing was also identified and the report of better use of the member for daily tasks demonstrated the patient’s satisfaction after the end of therapy. Conclusion: This case report demonstrated the benefits of the application of the CIMT method in a patient with ataxia as a consequence of a rare cerebellar tumor, improving task execution time, strength and functional improvement of the affected upper limb.

scholarly journals A case of cerebellar cognitive affective syndrome following left paramedian cerebellar tumor

2018 ◽  
Author(s):  
Oluwole Jegede
Keyword(s):  
Emergency Room ◽  
Psychiatric Symptoms ◽  
Cerebellar Tumor ◽  
Cerebellar Cognitive Affective Syndrome ◽  
Psychiatric Emergency Room ◽  
Affective Dysregulation ◽  
Acute Presentation ◽  
Acute Agitation ◽  
Impaired Cognition ◽  
Cerebellar Mass

We report the case of a 49-year-old man who presented to our psychiatric emergency room with acute agitation and disorganized behavior. The patient’s symptoms were an exacerbation of his reported chronic mood disorder concurrent with left paramedian cerebellar mass for which he underwent a surgical resection several years earlier. Associated with his acute psychiatric symptoms were findings of impaired cognition and altered perception. Diagnostic MRI done during index acute presentation revealed evidence of cerebellar mass regrowth. The disorders of cognition, mood and perceptions which involved a concurrent insult to the cerebellum is consistent with the diagnosis of Cerebellar Cognitive Affective Syndrome (CCAS). Our case underscores and strengthens the notion that the cerebellum plays a significant role in cognitive, mood and perceptual disturbances. Keywords: Cerebellar cognitive affective syndrome, Cerebellum, depression, Cognitive dysfunction, Affective dysregulation.

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