Neurocognitive outcome 12 months following cerebellar mutism syndrome in pediatric patients with medulloblastoma.
نویسندگان
چکیده
The aim is to prospectively assess early neurocognitive outcome of children who developed cerebellar mutism syndrome (CMS) following surgical resection of a posterior fossa embryonal tumor, compared with carefully matched control patients. Children who were enrolled on an ongoing IRB-approved protocol for treatment of embryonal tumors, were diagnosed with postoperative CMS, and had completed prospectively planned neuropsychological evaluation at 12 months postdiagnosis were considered eligible. The cognitive outcomes of these patients were examined in comparison to patients without CMS from the same treatment protocol and matched with regard to primary diagnosis, age at diagnosis, and risk/corresponding treatment (n = 22 pairs). Seventeen were also matched according to gender, and 14 were also matched according to race. High-risk patients received 36-39.6 Gy CSI and 3D conformal boost to the primary site to 55.8-59.4 Gy. Average-risk patients received 23.4 Gy CSI and 3D conformal boost to the primary site to 55.8 Gy. Significant group differences were found on multiple cognitive outcomes. While the matched control patients exhibited performance in the average range, patients who developed CMS postsurgery were found to have significantly lower performance in processing speed, attention, working memory, executive processes, cognitive efficiency, reading, spelling, and math. Patients treated for medulloblastoma who experience postoperative CMS show an increased risk for neurocognitive impairment, evident as early as 12 months following diagnosis. This study highlights the need for careful follow-up with neuropsychological evaluation and for obtaining critical support for patients and their families.
منابع مشابه
Cerebellar mutism following posterior fossa tumor resection in children.
AIM Cerebellar mutism is a documented complication of posterior fossa surgery in pediatric ages. Risk factors such as the type of tumor, size, and location of tumor, hyrdrocephalus, postoperative cerebellar swelling for cerebellar mutism were investigated in this study. MATERIAL AND METHODS A consecutive series of 32 children with a cerebellar tumor were operated on at the Haseki Educational ...
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Posterior fossa syndrome in children following tumor resection: Knowledge update
Case 1 A 2‐year‐old female presented with a 2‐month history of recalcitrant vomiting followed by ataxia and lethargy. Computed tomography (CT) scan of the head showed a large solid and cystic mass in the cerebellar vermis with severe hydrocephalus. Magnetic resonance imaging (MRI) demonstrated a 6.0 cm × 4.4 cm × 4.2 cm uniformly enhancing mass concerning for medulloblastoma with no evidence of...
متن کاملTransient internuclear ophthalmoparesis associated with mutism following midline cerebellar tumour surgery in an 8-year boy: A unique case
Mutism and neurobehaviour symptoms are well known features, which may occur following surgical excision of mass lesion of various histopathologies in the posterior cranial fossa, during the postoperative period. Mutism may be rarely associated with ataxia of eyelid closure and paresis of external ocular muscles. However, internuclear ophthalmoparesis is not reported in association with mutism f...
متن کاملTransient internuclear ophthalmoparesis associated with mutism following midline cerebellar tumour surgery in an 8-year boy
Mutism and neurobehaviour symptoms are well known features, which may occur following surgical excision of mass lesion of various histopathologies in the posterior cranial fossa, during the postoperative period. Mutism may be rarely associated with ataxia of eyelid closure and paresis of external ocular muscles. However, internuclear ophthalmoparesis is not reported in association with mutism f...
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عنوان ژورنال:
- Neuro-oncology
دوره 12 12 شماره
صفحات -
تاریخ انتشار 2010