Establishing reproducible predictors of cerebellar mutism syndrome based on pre-operative imaging
To establish some explicit, feasible, and reproducible predictors for CMS.
Materials and methods
This study was a retrospective case study. Data were obtained from 82 patients with medulloblastoma at a single center, Beijing Tiantan Hospital. Based on medical records, we created two independent samples: the CMS group comprising 23 patients and the non-CMS group comprising 23 patients. Pre-operative imaging was studied by performing quantitative assessments of specific indicators.
The CMS group showed greater differences in pre-operative imaging data with the non-CMS group. The Aaxi/daxi ratio in pre-operative MR imaging captured in the axial plane was used to quantify the compression of the cerebellum and brainstem, and significant differences were observed between the CMS group and non-CMS group (p = 0.0002). In the sagittal plane, Dsag*dsag was used to quantify the area of the tumor that invaded the brainstem, and significant differences were observed between the two groups (p = 0.0003). In the coronal plane, Acor/dcor was used to quantify the compression of the upper functional brain region, and significant differences were noted between the two groups (p = 0.0219). Additionally, Evans’ index was introduced to quantify the degree of hydrocephalus. The CMS group tended to show an increased Evans’ index (p = 0.0027).
Based on pre-operative imaging data, some reproducible predictors, such as Aaxi/daxi, Dsag*dsag, Acor/dcor, and Evans’ index, were established.
KeywordsCerebellar mutism syndrome Medulloblastoma Reproducible predictors Brainstem compression Surrounding edema Efferent cerebellar pathway
This study was funded by the Beijing Natural Science Foundation (7172041).
Compliance with ethical standards
Before the investigation, we received the approval of the Ethics Review Committee of the Beijing Tiantan Hospital
Conflict of interest
The authors declare that they have no conflict of interest.
- 1.Robertson PL, Muraszko KM, Holmes EJ, Sposto R, Packer RJ, Gajjar A, Dias MS, Allen JC (2006) Incidence and severity of post-operative cerebellar mutism syndrome in children with medulloblastoma: a prospective study by the Children’s Oncology Group. J Neurosurg 105:444–451. https://doi.org/10.3171/ped.2006.105.6.444 Google Scholar
- 4.Koh S, Turkel SB, Baram TZ (1997) Cerebellar mutism in children: report of six cases and potential mechanisms. Pediatr Neurol 16:218–219. https://doi.org/10.1016/S0887-8994(97)00018-0
- 6.Ellis DL, Kanter J, Walsh JW, Drury SS (2011) Posterior fossa syndrome after surgical removal of a pineal gland tumor. Pediatr Neurol 45:417–419. https://doi.org/10.1016/j.pediatrneurol.2011.09.011 CrossRefGoogle Scholar
- 8.Catsman-Berrevoets C, Patay Z (2018) Cerebellar mutism syndrome. Handb Clin Neurol 155:273–288. https://doi.org/10.1016/B978-0-444-64189-2.00018-4 CrossRefGoogle Scholar
- 13.Sergeant A, Kameda-Smith MM, Manoranjan B, Karmur B, Duckworth J, Petrelli T, Savage K, Ajani O, Yarascavitch B, Samaan MC, Scheinemann K, Alyman C, Almenawer S, Farrokhyar F, Fleming AJ, Singh SK, Stein N (2017) Analysis of surgical and MRI factors associated with cerebellar mutism. J Neuro-Oncol 133:539–552. https://doi.org/10.1007/s11060-017-2462-4 CrossRefGoogle Scholar