Tumour type and size are high risk factors for the syndrome of “cerebellar” mutism and subsequent dysarthria

• Published in: Journal of neurology, neurosurgery and psychiatry Vol. 67; no. 6; pp. 755 - 757
• Main Authors: Catsman-Berrevoets, Coriene E, Van Dongen, Hugo R, Mulder, Paul G H, y Geuze, Daniel Paz, Paquier, Philippe F, Lequin, Maarten H
• Format: Journal Article Conference Proceeding
• Language: English
• Published: London BMJ Publishing Group Ltd 01-12-1999; BMJ; BMJ Publishing Group LTD; BMJ Group
• Subjects: Adolescent; Age; Astrocytoma - diagnostic imaging; Astrocytoma - pathology; Astrocytoma - surgery; Biological and medical sciences; Cerebellar Neoplasms - diagnostic imaging; Cerebellar Neoplasms - pathology; Cerebellar Neoplasms - surgery; cerebellar tumour; Child; Child, Preschool; Children & youth; Cranial Fossa, Posterior - surgery; Dysarthria - diagnosis; Dysarthria - etiology; Ependymoma - diagnostic imaging; Ependymoma - pathology; Ependymoma - surgery; Female; Hemangioblastoma - diagnostic imaging; Hemangioblastoma - pathology; Hemangioblastoma - surgery; Humans; Localization; Magnetic Resonance Imaging; Male; Medical sciences; Medulloblastoma - diagnostic imaging; Medulloblastoma - pathology; Medulloblastoma - surgery; Meningitis; Mutism - diagnosis; Mutism - etiology; mutism and subsequent dysarthria; Neoplasm Invasiveness; Neoplasm Staging; Neurology; Postoperative Complications - etiology; Prospective Studies; Risk Factors; Severity of Illness Index; Software; Speech; Surgery; Syndrome; Tomography, X-Ray Computed; Tumors; Tumors of the nervous system. Phacomatoses; Variables; Human; Cerebellum; Postoperative; Nervous system diseases; Surgical resection; Language disorder; Cerebral disorder; Communication disorder; Cerebellar disease; Surgery; Central nervous system disease; Risk factor; Complication; Tumor; Mutism; Neurological disorder; Dysarthria; Child
• ISSN: 0022-3050; 1468-330X
• DOI: 10.1136/jnnp.67.6.755

OBJECTIVE “Cerebellar mutis” and subsequent dysarthria (MSD) is a documented complication of posterior fossa surgery in children. In this prospective study the following risk factors for MSD were assessed: type, size and site of the tumour; hydrocephalus at presentation and after surgery, cerebellar incision site, postoperative infection, and cerebellar swelling. METHODS In a consecutive series of 42 children with a cerebellar tumour, speech and neuroradiological studies (CT and MRI) were systematically analysed preoperatively and postoperatively. Speech was assessed using the Mayo Clinic lists and the severity of dysarthria using the Michigan rating scale. RESULTS Twelve children (29%) developed MSD postoperatively. The type of tumour, midline localisation, and vermal incision were significant single independent risk factors. In addition, an interdependency of possible risk factors (tumour>5 cm, medulloblastoma) was found. CONCLUSION MSD often occurs after paediatric cerebellar tumour removal and is most likely after removal of a medulloblastoma with a maximum lesion diameter>5 cm.