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Tumour type and size are high risk factors for the syndrome of “cerebellar” mutism and subsequent dysarthria
  1. Coriene E Catsman-Berrevoetsa,
  2. Hugo R Van Dongena,
  3. Paul G H Mulderd,
  4. Daniel Paz y Geuzeb,
  5. Philippe F Paquiere,
  6. Maarten H Lequinc
  1. aDepartment of Child Neurology, bDepartment of Child Neurosurgery, cDepartment of Child Radiology, Sophia Children Hospital, University Hospital Rotterdam, The Netherlands, dDepartment of Biostatistics and Epidemiology, Erasmus University Rotterdam, The Netherlands, eDepartment of Neurology University Hospital Erasme, Brussels, Belgium, and Department of Ear Nose and Throat Surgery, University of Antwerp, School of Medicine, Antwerp, Belgium
  1. Dr C E Catsman-Berrevoets, Department of Child Neurology, University Hospital Rotterdam, Sophia Children's Hospital, PO Box 2060, 3000 CB Rotterdam, The Netherlands. Telephone 0031 10 4636342; fax 0031 10 4636345; email Catsman{at}neur.azr.nl

Abstract

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.

  • mutism and subsequent dysarthria
  • cerebellar tumour
  • risk factors

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