scholarly journals Cerebellar Mutism After Pineal Tumour Excision: A Case Report

2011 ◽  
Vol 31 (2) ◽  
pp. 124-126 ◽  
Author(s):  
Yam Bahadur Roka ◽  
Manzil Shrestha ◽  
Pushpa Raj Puri ◽  
Sameer Aryal
Keyword(s):  
Posterior Fossa ◽  
Artery Occlusion ◽  
Basilar Artery Occlusion ◽  
Acute Subdural Hematoma ◽  
Pineal Tumor ◽  
Posterior Fossa Surgery ◽  
Cerebellar Mutism ◽  
Metabolic Disturbances ◽  
Glioma Surgery ◽  
Pineal Tumour

Cerebellar mutism syndrome (CMS) was first described by Rekate et al in 1985. This syndrome is a common complication of posterior fossa surgery in children with range of 11-29% and usually manifests as diminished speech, hypotonia, and ataxia. The cause is due to bilateral pertubation of the dentate nuclei and their efferent pathways by edema, perfusional defects, axonal damage or metabolic disturbances. Other rare causes of CMS like acute subdural hematoma of the posterior fossa, head injury, brainstem glioma surgery, meningitis and basilar artery occlusion have also been reported. CMS after supracerebellar resection of the pineal tumor is a very rare with very few cases reported. We report such a case in a 10- year old boy who underwent excision of a pineal tumor through the infratentorial supracerebellar route. Key Words: Cerebellar mutism; hydrocephalus; pineal tumor; posterior fossa. DOI: 10.3126/jnps.v31i2.4167 J Nep Paedtr Soc 2010;31(2):124-126  

scholarly journals Cerebellar Mutism after Posterior Fossa Surgery in the Child : A Case Report

1998 ◽  
Vol 7 (9) ◽  
pp. 591-595
Author(s):  
Toshihiro Ishibashi ◽  
Hiroyasu Nagahima ◽  
Kohichi Takahashi ◽  
Saroshi Sawauchi ◽  
Shigeyuki Murakami ◽  
...  
Keyword(s):  
Case Report ◽  
Posterior Fossa ◽  
Posterior Fossa Surgery ◽  
Cerebellar Mutism

Transient Cerebellar Mutism after Posterior Fossa Surgery in Children

Neurosurgery ◽  
1995 ◽  
Vol 37 (5) ◽  
pp. 894-897 ◽  
Author(s):  
Frank Van Calenbergh ◽  
Arnold Van De Laar ◽  
Chris Plets ◽  
Jan Goffin ◽  
Paul Casaer
Keyword(s):  
Posterior Fossa ◽  
Posterior Fossa Surgery ◽  
Cerebellar Mutism

Transient Cerebellar Mutism after Posterior Fossa Surgery in Children

Neurosurgery ◽  
1995 ◽  
Vol 37 (5) ◽  
pp. 894???898 ◽  
Author(s):  
Frank Van Calenbergh ◽  
Arnold Van De Laar ◽  
Chris Plets ◽  
Jan Goffin ◽  
Paul Casaer
Keyword(s):  
Posterior Fossa ◽  
Posterior Fossa Surgery ◽  
Cerebellar Mutism

scholarly journals A Paravermal Trans-Cerebellar Approach to the Posterior Fossa Tumor Causes Hypertrophic Olivary Degeneration by Dentate Nucleus Injury

Cancers ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 258
Author(s):  
Martin A. Schaller-Paule ◽  
Peter Baumgarten ◽  
Volker Seifert ◽  
Marlies Wagner ◽  
Eike Steidl ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Posterior Fossa ◽  
Dentate Nucleus ◽  
Clinical Syndrome ◽  
Surgical Removal ◽  
Posterior Fossa Surgery ◽  
Tumor Surgery ◽  
Cerebellar Mutism ◽  
Brain Tumor Surgery ◽  
Hypertrophic Olivary Degeneration

Background: In brain tumor surgery, injury to cerebellar connectivity pathways can induce a neurodegenerative disease called hypertrophic olivary degeneration (HOD), along with a disabling clinical syndrome. In children, cerebellar mutism syndrome (CMS) is another consequence of damage to cerebello–thalamo–cortical networks. The goal of this study was to compare paravermal trans-cerebellar to other more midline or lateral operative approaches in their risk of causing HOD on MR-imaging and CMS. Methods: We scanned our neurosurgical database for patients with surgical removal of pilocytic astrocytoma, ependymoma and medulloblastoma in the posterior fossa. Fifty patients with a mean age of 22.7 (±16.9) years were identified and analyzed. Results: HOD occurred in n = 10/50 (20%) patients within four months (median), always associated with contralateral dentate nucleus (DN)-lesions (p < 0.001). Patients with paravermal trans-cerebellar approach significantly more often developed HOD (7/11; 63.6%) when compared to other approaches (3/39; 7.7%; p < 0.001). Injury to the DN occurred more frequently after a paravermal approach (8/11 vs. 13/39 patients; p < 0.05). CMS was described for n = 12/50 patients (24%). Data indicated no correlation of radiological HOD and CMS development. Conclusions: A paravermal trans-cerebellar approach more likely causes HOD due to DN-injury when compared to more midline or lateral approaches. HOD is a radiological indicator for surgical disruption of cerebellar pathways involving the DN. Neurosurgeons should consider trajectories and approaches in the planning of posterior fossa surgery that spare the DN, whenever feasible.

scholarly journals Feasibility of cerebello-cortical stimulation for intraoperative neurophysiological monitoring of cerebellar mutism

2021 ◽  
Author(s):  
Davide Giampiccolo ◽  
Federica Basaldella ◽  
Andrea Badari ◽  
Giovanna Maddalena Squintani ◽  
Luigi Cattaneo ◽  
...  
Keyword(s):  
Motor Cortex ◽  
Test Stimulus ◽  
Posterior Fossa ◽  
Motor Evoked Potentials ◽  
Significant Inhibition ◽  
Neurophysiological Monitoring ◽  
Posterior Fossa Surgery ◽  
Cerebellar Mutism ◽  
Motor Cortex Excitability ◽  
Electrical Conditioning

Abstract Background Cerebellar mutism can occur in a third of children undergoing cerebellar resections. Recent evidence proposes it may arise from uni- or bilateral damage of cerebellar efferents to the cortex along the cerebello-dento-thalamo-cortical pathway. At present, no neurophysiological procedure is available to monitor this pathway intraoperatively. Here, we specifically aimed at filling this gap. Methods We assessed 10 patients undergoing posterior fossa surgery using a conditioning-test stimulus paradigm. Electrical conditioning stimuli (cStim) were delivered to the exposed cerebellar cortex at interstimulus intervals (ISIs) of 8–24 ms prior to transcranial electric stimulation of the motor cortex, which served as test stimulus (tStim). The variation of motor-evoked potentials (MEP) to cStim + tStim compared with tStim alone was taken as a measure of cerebello-cortical connectivity. Results cStim alone did not produce any MEP. cStim preceding tStim produced a significant inhibition at 8 ms (p < 0.0001) compared with other ISIs when applied to the lobules IV-V-VI in the anterior cerebellum and the lobule VIIB in the posterior cerebellum. Mixed effects of decrease and increase in MEP amplitude were observed in these areas for longer ISIs. Conclusions The inhibition exerted by cStim at 8 ms on the motor cortex excitability is likely to be the product of activity along the cerebello-dento-thalamo-cortical pathway. We show that monitoring efferent cerebellar pathways to the motor cortex is feasible in intraoperative settings. This study has promising implications for pediatric posterior fossa surgery with the aim to preserve the cerebello-cortical pathways and thus prevent cerebellar mutism.

Cerebellar mutism in adults after posterior fossa surgery: a report of 2 cases

2005 ◽  
Vol 63 (5) ◽  
pp. 476-479 ◽  
Author(s):  
Jonathan H. Sherman ◽  
Jason P. Sheehan ◽  
W. Jeffrey Elias ◽  
John A. Jane
Keyword(s):  
Posterior Fossa ◽  
Posterior Fossa Surgery ◽  
Cerebellar Mutism

scholarly journals Cerebellar Mutism after Basilar Artery Occlusion —Case Report—

1998 ◽  
Vol 38 (9) ◽  
pp. 569-573 ◽  
Author(s):  
Misao NISHIKAWA ◽  
Masaki KOMIYAMA ◽  
Hiroaki SAKAMOTO ◽  
Toshihiro YASUI ◽  
Hideki NAKAJIMA
Keyword(s):  
Case Report ◽  
Basilar Artery ◽  
Artery Occlusion ◽  
Basilar Artery Occlusion ◽  
Cerebellar Mutism

scholarly journals Cerebellar Mutism After Posterior Fossa Surgery —Two Case Reports—

1997 ◽  
Vol 37 (12) ◽  
pp. 929-933 ◽  
Author(s):  
Yutaka KAI ◽  
Jun-ichi KURATSU ◽  
Kenji SUGINOHARA ◽  
Toru MARUBAYASHI ◽  
Yukitaka USHIO
Keyword(s):  
Posterior Fossa ◽  
Case Reports ◽  
Posterior Fossa Surgery ◽  
Cerebellar Mutism
Sign in / Sign up

Export Citation Format

Share Document