The ASsessment and Physiotherapy managEment of Ataxia in Children Following Surgical Resection of Posterior Fossa Tumour

Abstract Purpose To report the course of ataxia in children up to 2 years post-operatively, following surgical resection of a posterior fossa tumour (PFT). Methods Thirty-five children, (median age 9 years, range 4–15) having resection of PFT, were assessed using the Scale for the Assessment and Rating of Ataxia (SARA), Brief Ataxia Rating Scale (BARS) and the mobility domain of the Paediatric Evaluation of Disability Index (PEDI-m) at initial post-operative period (baseline), 3 months, 1 year and 2 years post-operatively. Results Baseline median scores of the SARA and BARS were 8.5 (range 0–35.5), and 7 (0–25) respectively. Ataxia improved at 3 months (median SARA and BARS reduction 3.5 and 4, respectively). Additional gradual improvements in SARA were recorded at 1 (median reduction 2) and 2 years post-operatively (median reduction 0.5). Median baseline PEDI-m was 54.75 (range 15.2–100) with improvement at 3 months (median increase 36.95) and small improvement at 1 year (median increase 2.5) and 2 years (median increase 5.8). Children with medulloblastoma and midline tumours (median baseline SARA 10 and 11, respectively) demonstrated more severe ataxia than children with low-grade gliomas and unilateral tumours (median baseline SARA 7.5 and 6.5, respectively). Conclusion The largest improvement in ataxia scores and functional mobility scores is demonstrated within the first 3 months post-operatively, but ongoing gradual improvement is observed at 2 years. Children with medulloblastoma and midline tumour demonstrated higher ataxia scores long term.

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E-survey of current international physiotherapy practice for children with ataxia following surgical resection of posterior fossa tumour

Journal of Rehabilitation Medicine – Clinical Communications ◽

10.2340/20030711-1000020 ◽

2019 ◽

Vol 2 (1) ◽

pp. 1000020

Author(s):

H Hartley ◽

B Carter ◽

L Bunn ◽

B Pizer ◽

S Lane ◽

...

Keyword(s):

Surgical Resection ◽

Posterior Fossa ◽

Posterior Fossa Tumour ◽

Physiotherapy Practice

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Posterior fossa tuberculoma in a 9-year old boy mimicking posterior fossa tumour

10.26226/morressier.578f37fbd462b8028d890041 ◽

2016 ◽

Author(s):

Thanikachalm Pasupati Meenakshi

Keyword(s):

Posterior Fossa ◽

Posterior Fossa Tumour

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IMG-18. ASSESSMENT OF SUSPECTED DISEASE PROGRESSION USING MULTIPARAMETRIC 18F-CHOLINE PET/MRI IN CHILDHOOD AND TEENAGE-YOUNG ADULT GLIOMAS

Neuro-Oncology ◽

10.1093/neuonc/noaa222.353 ◽

2020 ◽

Vol 22 (Supplement_3) ◽

pp. iii358-iii358

Author(s):

Valentina Ferrazzoli ◽

Ananth Shankar ◽

Julia Cockle ◽

Christine Tang ◽

Ahmed Al-khayfawee ◽

...

Keyword(s):

Disease Progression ◽

Posterior Fossa ◽

Cerebral Blood Volume ◽

Posterior Fossa Tumour ◽

Recurrent Tumour ◽

Normal Appearing White Matter ◽

Conventional Mri ◽

Apparent Diffusion ◽

Teenagers And Young Adults

Abstract OBJECTIVES Evaluation of post-treatment glioma burden remains a significant challenge in children, teenagers and young adults (TYA). The aim of this study was to evaluate the utility of ChoPET/MRI for evaluation of suspected disease progression in childhood and TYA gliomas. METHODS 27 patients (mean age 14 years, range 6–21 years) with suspected glioma disease progression were evaluated with ChoPET/MRI (n=59). Relative cerebral blood volume (rCBV), apparent diffusion coefficient (ADC) and maximum standardised uptake values (SUVmax) in enhancing (enh) and non-enhancing (ne) tumour and normal-appearing white matter (wm) were calculated (rCBVenh, rCBVne, rCBVwm, ADCenh, ADCne, ADCwm, SUVenh, SUVne, SUVwm). 2 blinded radiologists scored tumour probability (1 = unlikely; 5 = definitely). Sensitivity and specificity calculated with gold standard histopathology or clinical follow-up. RESULTS Accuracy for the detection of residual/recurrent tumour on conventional MRI was 96.3% (91.7% ≤14 years, 100% ≥15 years) and ChoPET was 73.1% (66.7% ≤14 years, 80.0% ≥15 years). Lack of agreement was observed in 9/27 patients, with ChoPET superior to MRI in 1 case of a posterior fossa tumour. Tumour component analysis demonstrated significantly higher SUVenh and SUVne than SUVwm (SUVenh: p<0.001; SUVne: p=0.004, equivalent to results were observed for ADV and rCBV (ADCenh, ADCne: p<0.001 vs ADCwm; rCBVenh, rCBVne: p<0.001 vs rCBVwm). CONCLUSIONS MRI is more sensitive than ChoPET in the evaluation of suspected disease progression in TYA gliomas. However, quanititative ChoPET is able to detect enhancing and non-enhancing tumour and may be helpful in evaluating posterior fossa disease where MRI is equivocal.

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Audit of regional screening guidelines for vestibular schwannoma

The Journal of Laryngology & Otology ◽

10.1017/s0022215100141891 ◽

1998 ◽

Vol 112 (9) ◽

pp. 860-864 ◽

Cited By ~ 24

Author(s):

P. J. D. Dawes ◽

J.-P. Jeannon

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Posterior Fossa ◽

Vestibular Schwannoma ◽

Acoustic Neuroma ◽

Resonance Imaging ◽

Posterior Fossa Tumour ◽

Screening Guidelines ◽

Magnetic Resonance Imaging Mri

AbstractAn audit of 334 patients who underwent magnetic resonance imaging (MRI) as investigation for a possible diagnosis of vestibular schwannoma was carried out to assess adherence to previously agreed screening guidelines. This represents one year's activity. A posterior fossa tumour was identified in 12 patients. Scan requests were judged to be inappropriate for 28 cases. The issues surrounding the screening for acoustic neuroma are discussed.

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Surgical Management Of Posterior Fossa Arteriovenous Malformations

Operative Neurosurgery ◽

10.1227/01.neu.0000204641.38419.2d ◽

2006 ◽

Vol 58 (suppl_4) ◽

pp. ONS-189-ONS-201 ◽

Cited By ~ 6

Author(s):

John Sinclair ◽

Michael E. Kelly ◽

Gary K. Steinberg

Keyword(s):

Stereotactic Radiosurgery ◽

Surgical Resection ◽

Posterior Fossa ◽

Arteriovenous Malformations ◽

Cranial Nerves ◽

Venous Drainage ◽

Cerebellar Nuclei ◽

Preoperative Embolization ◽

Frameless Stereotaxy ◽

Microsurgical Resection

Abstract Objective: Arteriovenous malformations (AVMs) involving the cerebellum and brainstem are relatively rare lesions that most often present clinically as a result of a hemorrhagic episode. Although these AVMs were once thought to have a more aggressive clinical course in comparison with supratentorial AVMs, recent autopsy data suggests that there may be little difference in hemorrhage rates between the two locations. Although current management of these lesions often involves preoperative embolization and stereotactic radiosurgery, surgical resection remains the treatment of choice, conferring immediate protection to the patient from the risk of future hemorrhage. Methods: Most symptomatic AVMs that involve the cerebellum and the pial or ependymal surfaces of the brainstem are candidates for surgical resection. Preoperative angiography and magnetic resonance imaging studies are critical to determine suitability for resection and choice of operative exposure. In addition to considering the location of the nidus, arterial supply, and predominant venous drainage, the surgical approach must also be selected with consideration of the small confines of the posterior fossa and eloquence of the brainstem, cranial nerves, and deep cerebellar nuclei. Results: Since the 1980s, progressive advances in preoperative embolization, frameless stereotaxy, and intraoperative electrophysiologic monitoring have significantly improved the number of posterior fossa AVMs amenable to microsurgical resection with minimal morbidity and mortality. Conclusion: Future improvements in endovascular technology and stereotactic radiosurgery will likely continue to increase the number of posterior fossa AVMs that can safely be removed and further improve the clinical outcomes associated with microsurgical resection.

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Extra-axial tentorial medulloblastoma: a rare presentation of a common posterior fossa tumour

BMJ Case Reports ◽

10.1136/bcr-2021-242865 ◽

2021 ◽

Vol 14 (6) ◽

pp. e242865

Author(s):

Somesh Singh ◽

Amrin Israrahmed ◽

Vikrant Verma ◽

Vivek Singh

Keyword(s):

Differential Diagnosis ◽

Posterior Fossa ◽

Fourth Ventricle ◽

Imaging Features ◽

Total Excision ◽

Posterior Fossa Tumour ◽

Rare Presentation ◽

Preoperative Workup ◽

Radiological Features ◽

Axial Mass

Medulloblastoma is a common paediatric posterior fossa tumour typically presenting as midline intra-axial mass involving the cerebellar vermis and/or roof of fourth ventricle with typical radiological features. These can be extra-axial in extremely rare instances with less than 50 cases reported so far in literature. We present a case of 18-year-old boy presenting with ataxia and headache. MRI showed dural mass (involving the left tentorium cerebellum) with typical imaging features of extra-axial lesion. The patient underwent near total excision of the tumour. Histopathology along with immunohistochemistry revealed the mass to be medulloblastoma. We present this case to highlight rarity of this location for medulloblastoma and the importance of considering this in the differential diagnosis of atypical posterior fossa extra-axial lesions. This can help in performing other relevant preoperative workup similar on the lines of medulloblastoma and planning of relevant management.

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