Cerebellar Mutism Syndrome following Midline Posterior Fossa Tumor Resection in Children: An Institutional Experience

Aim: Cerebellar mutism (CM) syndrome is a well-known and annoying complication of posterior fossa surgery in the pediatric age group. Risk factors such as the type of tumor, size, involvement of posterior fossa structures and hydrocephalus, and postoperative cerebellar swelling for CM were investigated in this study. Materials and Methods: A consecutive series of 33 children with midline posterior fossa tumors were operated at the SMS Medical College and Hospital, Department of Neurosurgery, Jaipur India, between September 2015 and December 2016. Their speech and neuroradiological studies were systematically analyzed both preoperatively and postoperatively. Results: CM syndrome (CMS) developed in six children (18.18%) in the early postoperative period. The pre- and post-operative irritability, medulloblastoma histology, maximum size more than 45 mm, involvement of superior cerebellar peduncles, and vermian incision were significant single independent risk factors. In addition, male gender also associated with a higher risk for CMS. The latency for the development of mutism ranged from 1 to 12 days (mean 3.5 days). The speech returned to normal in all patients. All cases with CMS accompanied by cerebellar ataxia. Conclusion: The medulloblastoma, irritability, maximum size more than 45 mm, involvement of superior cerebellar peduncles, and vermian incision were significant single independent risk factors for postoperative pediatric CMS. Mutism after posterior fossa tumor resection is also accompanied with ataxia. CM usually has a self-limiting course and a favorable prognosis.

• Publication year

  2017

• Venue

  Journal of Pediatric Neurosciences

• Publication date

  2017-10-01

• Fields of study

  Medicine

• Identifiers
  DOI 10.4103/jpn.JPN_23_17PMID 29675068PMCID 5890549
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• Consensus paper on post-operative pediatric cerebellar mutism syndrome: the Iceland Delphi results

  2016cited by this paper
• Chemotherapy for children with medulloblastoma.

  2015cited by this paper
• Pediatric cerebellar astrocytoma: a review

  2015cited by this paper
• Treatment developments and the unfolding of the quality of life discussion in childhood medulloblastoma: a review

  2014cited by this paper
• Fronto-cerebellar fiber tractography in pediatric patients following posterior fossa tumor surgery

  2013cited by this paper
• Clinical and neuroanatomical predictors of cerebellar mutism syndrome.

  2012cited by this paper
• Cerebellar mutism

  2011cited by this paper
• Ependymoma: An Update

  2009cited by this paper
• Childhood Brain Tumors: Accomplishments and Ongoing Challenges

  2008cited by this paper
• The cerebellar mutism syndrome and its relation to cerebellar cognitive function and the cerebellar cognitive affective disorder.

  2008cited by this paper
• Cerebellar mutism following posterior fossa tumor resection in children.

  2008cited by this paper
• The effect of damage to the cerebellum on sensorimotor and cognitive function in children and adolescents.

  2007cited by this paper
• Persistent psychosocial problems in children who develop posterior fossa syndrome after medulloblastoma resection

  2007cited by this paper
• Posterior Fossa Syndrome after a Vermian Stroke: A New Case and Review of the Literature

  2007cited by this paper
• Transient cerebellar mutism caused by bilateral damage to the dentate nuclei after the second posterior fossa surgery. Case report.

  2006cited by this paper
• Long-term effects of transient cerebellar mutism after cerebellar astrocytoma or medulloblastoma tumor resection in childhood

  2006cited by this paper
• The pathophysiologic mechanism of cerebellar mutism.

  2006cited by this paper
• Incidence and severity of postoperative cerebellar mutism syndrome in children with medulloblastoma: a prospective study by the Children's Oncology Group.

  2006cited by this paper
• Medulloblastoma in childhood. Survival and functional results

  2005cited by this paper
• Cerebellar mutism

  2004cited by this paper
• The Evaluation and Comparison of Cerebellar Mutism in Children and Adults after Posterior Fossa Surgery: Report of two Adult Cases and Review of the Literature

  2002cited by this paper
• Single photon emission tomography following posterior fossa surgery in patients with and without mutism

  2002cited by this paper
• Mutism after posterior fossa surgery. Review of the literature.

  2001cited by this paper
• The cerebellum contributes to higher functions during development: evidence from a series of children surgically treated for posterior fossa tumours.

  2000cited by this paper
• Neurological Dysfunction Associated With Postoperative Cerebellar Mutism

  2000cited by this paper
• Posterior Fossa Syndrome: Identifiable Risk Factors and Irreversible Complications

  1999cited by this paper
• Tumour type and size are high risk factors for the syndrome of “cerebellar” mutism and subsequent dysarthria

  1999cited by this paper
• Posterior vermal split syndrome

  1998cited by this paper
• Cerebellar mutism: report of seven cases and review of the literature.

  1996cited by this paper
• Transient mutism following a posterior fossa approach to cerebellar tumors in children: a critical review of the literature

  1995cited by this paper
• The surgical and natural morbidity of aggressive resection for posterior fossa tumors in childhood.

  1994cited by this paper
• Postoperative mutism in neurosurgery. Report of two cases.

  1994cited by this paper
• Transient mutism following removal of a cerebellar tumor

  1989cited by this paper
• Current neurosurgical treatment of medulloblastomas in children. A report from the Children's Cancer Study Group.

  1989cited by this paper
• Muteness of cerebellar origin.

  1985cited by this paper
• Pseudobulbar palsy after posterior fossa operation in children.

  1984cited by this paper

• Pre-operative and intra-operative risk factors of post-operative cerebellar mutism syndrome in pediatric patients undergoing posterior fossa tumor surgery: a systematic review

  2026cites this paper
• Incidence and management of posterior fossa syndrome in children at a tertiary care hospital in Karachi: A 10-year retrospective cohort

  2025influential citation
• Sex as an independent risk factor for cerebellar mutism syndrome: a validation study

  2025cites this paper
• Radiological Predictors of Cognitive Impairment in Paediatric Brain Tumours Using Multiparametric Magnetic Resonance Imaging: A Review of Current Practice, Challenges and Future Directions

  2025cites this paper
• Complications following resection of primary and recurrent pediatric posterior fossa ependymoma.

  2024cites this paper
• National multicentered retrospective review of clinical and intraoperative factors associated with the development of cerebellar mutism after pediatric posterior fossa tumor resection

  2024cites this paper
• Neuroimaging of postoperative pediatric cerebellar mutism syndrome: a systematic review

  2024cites this paper
• Predicting cerebellar mutism syndrome in children using lesion map combined with clinical features

  2024cites this paper
• Neuroanatomy of autism: what is the role of the cerebellum?

  2024cites this paper
• Presurgical MRI‐Based Radiomics Models for Predicting Cerebellar Mutism Syndrome in Children With Posterior Fossa Tumors

  2023cites this paper
• Long-term postoperative quality of life in childhood survivors with cerebellar mutism syndrome

  2023cites this paper
• The Cerebellar Mutism Syndrome: Risk Assessment, Prevention and Treatment.

  2023cites this paper
• Diffusion Tensor Imaging Technique Delineating the Prognosis for Cerebellar Mutism in Posterior Fossa Tumors: A New Tool.

  2023cites this paper
• Fractal dimension as a predictive biomarker for tumor grade and cerebellar mutism syndrome in pediatric posterior fossa tumors

  2023cites this paper
• Occipital interhemispheric transtentorial approach in pediatric patients for lesions of the superomedial cerebellum: operative findings and results

  2022cites this paper
• Postoperative MRI features of cerebellar mutism syndrome: a retrospective cohort study.

  2022cites this paper
• Male Predisposition in Cerebellar Mutism Syndrome: a Cohort Study

  2022cites this paper
• A presurgical voxel-wise predictive model for cerebellar mutism syndrome in children with posterior fossa tumors

  2022cites this paper
• Risk factors for postoperative cerebellar mutism syndrome in pediatric patients: a systematic review and meta-analysis.

  2021cites this paper
• Cerebellar Mutism Syndrome: An Overview of the Pathophysiology in relation to the Cerebrocerebellar Anatomy, Risk Factors, Potential Treatments and Outcomes.

  2021cites this paper
• Management and outcome of pediatric brainstem and cerebellar peduncular low-grade gliomas: a retrospective analysis of 62 cases

  2021cites this paper
• Survival status and predictors of mortality among children who underwent ventriculoperitoneal shunt surgery at public hospitals in Addis Ababa, Ethiopia

  2021cites this paper
• Evaluation of Childhood Posterior Fossa Malignant Tumors: A Single-center Study

  2020influential citation
• Neuropsychological Profile in Children with Posterior Fossa Tumors with or Without Postoperative Cerebellar Mutism Syndrome (CMS)

  2019cites this paper
• Cerebellar Mutism: Surgical Perspectives

  2018cites this paper